MEDICARE: MS. SUSAN MICHELLE ADKINS RN

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
1	163W00000X	Registered Nurse	57030	WV

General Provider Information

NPI Number	:	1477788370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN MICHELLE ADKINS RN

Provider Business Mailing Address
First Line	:	109 MCKINLEY ST
Second Line	:
City	:	CRAB ORCHARD
State	:	WV
Zip	:	25827-9409
Country	:	US
Telephone Number	:	304-254-4255
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 MCKINLEY ST
Second Line	:
City	:	CRAB ORCHARD
State	:	WV
Zip	:	25827-9409
Country	:	US
Telephone Number	:	304-254-4255
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2009
Last Update Date	:	08/13/2025

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