Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 201907743NP-PP | OR |
N | 363LG0600X | Nurse Practitioner - Gerontology | 201907743NP-PP | OR |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 828531 | NV |
NPI | 1053955047 |
---|---|
Provider Name | Bethany Adams |
First Address | Carson City, NV 89703-4625 |
Second Address | Carson City, NV 89703-4625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2019 |
Last Update Date | 30/03/2020 |