MEDICARE: KYIANA ADAMS NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024171762	VA
2	363L00000X	Nurse Practitioner	0001178199	VA

General Provider Information

NPI Number	:	1760896815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYIANA ADAMS NP

Provider Business Mailing Address
First Line	:	POTOMAC CENTER OFFICE
Second Line	:	2296 OPITZ BLVD., STE. 300
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191
Country	:	US
Telephone Number	:	703-523-0998
Fax Number	:

Provider Business Practice Location Address
First Line	:	POTOMAC CENTER OFFICE
Second Line	:	2296 OPITZ BLVD., STE. 300
City	:	WOODBRIDGE
State	:	VA
Zip	:	22191-3354
Country	:	US
Telephone Number	:	703-523-0998
Fax Number	:

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

Provider Enumeration Date	:	06/17/2014
Last Update Date	:	12/16/2025

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