Healthcare Provider Details

I. General information

NPI: 1083819544
Provider Name (Legal Business Name): LAURA E ADAMS MSN, RNC, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 OAKHURST DR
CHARLESTON WV
25314-2044
US

IV. Provider business mailing address

1003 OAKHURST DR
CHARLESTON WV
25314-2044
US

V. Phone/Fax

Practice location:
  • Phone: 304-345-4525
  • Fax: 304-345-4527
Mailing address:
  • Phone: 304-345-4525
  • Fax: 304-345-4527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number62297
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: