Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 2016038494 | MO |
NPI | 1003393513 |
---|---|
Provider Name | Alina V Adams |
First Address | Saint Louis, MO 63195-1845 |
Second Address | Richmond Heights, MO 63117-1845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2018 |
Last Update Date | 30/10/2020 |