MEDICARE: MS. ANDREA DAWN ADKINS ARNP-C

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	363LF0000X	Family Nurse Practitioner	ARNP1645912	FL
2	363LA2200X	Adult Health Nurse Practitioner	ARNP1645912	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DA5786	OTHER	FL	RAILROAD MEDICARE GROUP ID NUMBER / LRHSI
4	Y8489Y	OTHER	FL	MEDICARE PTAN / LRHSI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	1497748743	OTHER	GROUP NPI NUMBER/ LRHSI
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871589101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANDREA DAWN ADKINS ARNP-C

Provider Business Mailing Address
First Line	:	PO BOX 95004
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33804-5004
Country	:	US
Telephone Number	:	863-680-7000
Fax Number	:	863-680-7420

Provider Business Practice Location Address
First Line	:	4315 HIGHLAND PARK BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-1639
Country	:	US
Telephone Number	:	863-816-5884
Fax Number	:	813-792-4745

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	11/06/2013

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