Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4704262916 | MI |
N | 111NI0900X | Internist | 4704262916 | MI |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 0024176176 | VA |
NPI | 1013424431 |
---|---|
Provider Name | Ms. Mary Elizabeth Adams |
First Address | Newport News, VA 23601-1318 |
Second Address | Gloucester, VA 23061-4351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2018 |
Last Update Date | 17/02/2020 |