Provider Demographics
NPI:1952381857
Name:MILLETT, ADRIENNE JESSICA (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIENNE
Middle Name:JESSICA
Last Name:MILLETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 GERI LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2304
Mailing Address - Country:US
Mailing Address - Phone:859-623-2020
Mailing Address - Fax:859-623-0346
Practice Address - Street 1:238 GERI LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2304
Practice Address - Country:US
Practice Address - Phone:859-623-2020
Practice Address - Fax:859-623-0346
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2015-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY18437207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC65736Medicare UPIN
KYC65736Medicare UPIN