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NPI Code Detail

MEDICARE: ADELAIDE ADJOVU NP

MEDICARE: ADELAIDE ADJOVU NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner101.0131968VT

General Provider Information

NPI Number : 1093227571
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADELAIDE ADJOVU NP
Provider Business Mailing Address
First Line : 42 HYDE ST APT 1
Second Line :
City : BURLINGTON
State : VT
Zip : 05401-3629
Country : US
Telephone Number : 702-283-8060
Fax Number :
Provider Business Practice Location Address
First Line : 195 INDUSTRIAL PKWY
Second Line :
City : LYNDONVILLE
State : VT
Zip : 05851-4511
Country : US
Telephone Number : 802-748-9501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2017
Last Update Date : 10/24/2017

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