Healthcare Provider Details

I. General information

NPI: 1114226099
Provider Name (Legal Business Name): CLAUDIA ADRIAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 SE INDIAN ST FL 2
STUART FL
34997-5604
US

IV. Provider business mailing address

770 SE INDIAN ST FL 2
STUART FL
34997-5604
US

V. Phone/Fax

Practice location:
  • Phone: 772-779-8120
  • Fax:
Mailing address:
  • Phone: 772-779-8120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9264901
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberARNP9264901
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: