Healthcare Provider Details

I. General information

NPI: 1376975177
Provider Name (Legal Business Name): ADRIENNE LOUISE DENSON R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2013
Last Update Date: 08/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 ASHLEY AVE
MIDDLETOWN NY
10940-1912
US

IV. Provider business mailing address

45 ASHLEY AVE
MIDDLETOWN NY
10940-1912
US

V. Phone/Fax

Practice location:
  • Phone: 845-326-8073
  • Fax: 845-326-8003
Mailing address:
  • Phone: 845-326-8073
  • Fax: 845-326-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number489623
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: