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General NPI Number Information
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NPI Number | 1538584131
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Entity Type | Individual
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Provider Name | LYDIA ADAMS
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Gender | Female
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Dates
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Enumeration Date | 02/19/2014
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Last Update Date | 10/27/2017
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Provider Practice Location Address
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Address Line | 901 MONTGOMERY ST
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City | DECORAH
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State | IA
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Zip | 52101-2325
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Country | US
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Telephone | 563-382-2911
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Fax |
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Provider Business Mailing Address
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Address Line | 22564 306TH ST
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City | WAUCOMA
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State | IA
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Zip | 52171-7164
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Country | US
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Telephone | 641-220-2215
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | D120926
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 122
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License Number State | MN
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