Healthcare Provider Details

I. General information

NPI: 1356117311
Provider Name (Legal Business Name): INELL ADAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 11/30/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 W 38TH PL
LOS ANGELES CA
90062-1007
US

IV. Provider business mailing address

1718 W 38TH PL
LOS ANGELES CA
90062-1007
US

V. Phone/Fax

Practice location:
  • Phone: 323-819-6617
  • Fax:
Mailing address:
  • Phone: 323-819-6617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95027244
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number95027244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: