MEDICARE: MS. VICTORIA P ADAWAY CNS

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	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	1-036298	AL

General Provider Information

NPI Number	:	1285664292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICTORIA P ADAWAY CNS

Provider Business Mailing Address
First Line	:	PO BOX 531291
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35253-1291
Country	:	US
Telephone Number	:	205-307-8046
Fax Number	:	205-338-4464

Provider Business Practice Location Address
First Line	:	1602 COGSWELL AVE
Second Line	:
City	:	PELL CITY
State	:	AL
Zip	:	35125-1645
Country	:	US
Telephone Number	:	205-307-8046
Fax Number	:	205-338-4464

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	04/06/2015

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