Healthcare Provider Details

I. General information

NPI: 1619773215
Provider Name (Legal Business Name): AMBER LYNN ADKINS CNS, LDN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 COLD BOTTOM RD
SPARKS GLENCOE MD
21152-9509
US

IV. Provider business mailing address

908 COLD BOTTOM RD
SPARKS GLENCOE MD
21152-9509
US

V. Phone/Fax

Practice location:
  • Phone: 302-668-9153
  • Fax:
Mailing address:
  • Phone: 302-668-9153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDX7138
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR229845
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: