Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | ARNP3138612 | FL |
Y | 363LP2300X | Nurse Practitioner - Primary Care | ARNP3138612 | FL |
NPI | 1063882264 |
---|---|
Provider Name | Rebecca Adams |
First Address | Green Cove Springs, FL 32043-3618 |
Second Address | Green Cove Springs, FL 32043-4025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2015 |
Last Update Date | 30/04/2020 |