Healthcare Provider Details

I. General information

NPI: 1912987025
Provider Name (Legal Business Name): MARILU ADAMS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 BRECKENRIDGE ST DAVIESS COUNTY HEALTH CENTER
OWENSBORO KY
42303-1055
US

IV. Provider business mailing address

PO BOX 309 GREEN RIVER DISTRICT HEALTH DEPARTMENT
OWENSBORO KY
42302-0309
US

V. Phone/Fax

Practice location:
  • Phone: 270-686-7744
  • Fax: 270-926-8677
Mailing address:
  • Phone: 270-686-7747
  • Fax: 270-926-9862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2516M
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number3002516
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: