Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 71007734A | IN |
N | 363LA2200X | Nurse Practitioner - Adult Health | 71007734A | IN |
N | 363LG0600X | Nurse Practitioner - Gerontology | 71007734A | IN |
N | 363LP2300X | Nurse Practitioner - Primary Care | 71007734A | IN |
NPI | 1013425131 |
---|---|
Provider Name | Mr. Adam Kristofer Pinkerton |
First Address | Roanoke, IN 46783-9479 |
Second Address | Roanoke, IN 46783 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2018 |
Last Update Date | 26/09/2019 |