Healthcare Provider Details

I. General information

NPI: 1780241182
Provider Name (Legal Business Name): ADRIENNE LENDSEY HINTON DIAZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OPTUM CIR
EDEN PRAIRIE MN
55344-2956
US

IV. Provider business mailing address

1 OPTUM CIR
EDEN PRAIRIE MN
55344-2956
US

V. Phone/Fax

Practice location:
  • Phone: 800-561-0861
  • Fax:
Mailing address:
  • Phone: 800-561-0861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number22895
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number231836
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: