MEDICARE: MARY ROBIN ADAMS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	RN184583	GA
2	363LP2300X	Primary Care Nurse Practitioner	RN184583	GA

General Provider Information

NPI Number	:	1023860806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ROBIN ADAMS APRN

Provider Business Mailing Address
First Line	:	635 FULLIER CIR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-7993
Country	:	US
Telephone Number	:	404-683-0005
Fax Number	:

Provider Business Practice Location Address
First Line	:	635 FULLIER CIR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-7993
Country	:	US
Telephone Number	:	404-683-0005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2024
Last Update Date	:	04/03/2024

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Directions to “ MARY ROBIN ADAMS APRN” Practice Location

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