Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 03569 | KY |
Y | 207Q00000X | Family Doctor | 169535 | AK |
N | 207Q00000X | Family Doctor | 5006 | OK |
N | 207QS0010X | Family Doctor - Sports Medicine | 5006 | OK |
NPI | 1245566181 |
---|---|
Provider Name | Dianne Elizabeth Adams |
First Address | Talkeetna, AK 99676 |
Second Address | Talkeetna, AK 99676 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2009 |
Last Update Date | 18/06/2021 |