Healthcare Provider Details

I. General information

NPI: 1447550314
Provider Name (Legal Business Name): MELISSA N ADAMS WHCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2010
Last Update Date: 04/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NE NEFF RD STE A
BEND OR
97701
US

IV. Provider business mailing address

2400 NE NEFF RD STE A
BEND OR
97701-6752
US

V. Phone/Fax

Practice location:
  • Phone: 541-389-3300
  • Fax: 541-389-8115
Mailing address:
  • Phone: 541-389-3300
  • Fax: 541-389-8115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number201050198NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: