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General NPI Number Information
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NPI Number | 1417402280
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Entity Type | Individual
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Provider Name | IAN JAMES ADAMS
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Gender | Male
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Dates
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Enumeration Date | 08/22/2016
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 100 BISQUE DR
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City | HENDERSON
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State | NV
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Zip | 89074-8302
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Country | US
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Telephone | 775-220-7885
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Fax |
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Provider Business Mailing Address
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Address Line | 310 PINE ST #1
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-3844
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Country | US
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Telephone | 775-220-7885
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP8926
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License Number State | AZ
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