Healthcare Provider Details

I. General information

NPI: 1174876908
Provider Name (Legal Business Name): ANDREA R ADAMS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 CHERRY ST SUITE M200
TOLEDO OH
43608-2673
US

IV. Provider business mailing address

2200 JEFFERSON AVE 5TH FLOOR
TOLEDO OH
43604-7101
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-8019
  • Fax: 419-251-5819
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.13592
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License NumberRN.303167-COA1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: