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General NPI Number Information
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NPI Number | 1427042704
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Entity Type | Individual
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Provider Name | VIVIAN C. ADAMOWICZ CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 68377 STEWART DR STE 202
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City | SAINT CLAIRSVILLE
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State | OH
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Zip | 43950-1718
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Country | US
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Telephone | 740-699-2747
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6230
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City | WHEELING
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State | WV
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Zip | 26003-0722
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Country | US
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Telephone | 304-242-7106
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Fax | 304-242-7108
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | COA10305NA
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License Number State | OH
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