Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | F06172114 | MS |
N | 363LC1500X | Nurse Practitioner - Community Health | F06172114 | MS |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 95007880 | CA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F06172114 | MS |
N | 363LP2300X | Nurse Practitioner - Primary Care | F06172114 | MS |
NPI | 1366863888 |
---|---|
Provider Name | Lareina Renee' Adams |
First Address | Porterville, CA 93257-3257 |
Second Address | Porterville, CA 93257-3257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2013 |
Last Update Date | 16/07/2020 |