Healthcare Provider Details

I. General information

NPI: 1275042871
Provider Name (Legal Business Name): ABBY K ADAMS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 09/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E BYPASS 287
ALVORD TX
76225-7778
US

IV. Provider business mailing address

115 E BYPASS 287
ALVORD TX
76225-7778
US

V. Phone/Fax

Practice location:
  • Phone: 940-427-2858
  • Fax: 940-427-2857
Mailing address:
  • Phone: 940-627-8982
  • Fax: 940-627-7464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number855470
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: