1356540835 NPI number — MS. ELIZABETH ELAINE ADAMS

Table of content: MS. ELIZABETH ELAINE ADAMS (NPI 1356540835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356540835 NPI number — MS. ELIZABETH ELAINE ADAMS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADAMS
Provider First Name:
ELIZABETH
Provider Middle Name:
ELAINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356540835
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
BLANCHFIELD ACH, PREVENTIVE MEDICINE, PUBLIC HEALTH NUR
Provider Second Line Business Mailing Address:
USA MEDDAC, BLDG. 2506 INDIANA ST AND 24TH ST.
Provider Business Mailing Address City Name:
FORT CAMPBELL
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-956-0100
Provider Business Mailing Address Fax Number:
270-956-0124

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BLANCHFIELD ARMY COMMUNITY HOSPITAL/PM/PUBLIC HEALTH NU
Provider Second Line Business Practice Location Address:
BLDG 2506 ON 24TH AND INDIANA ST.
Provider Business Practice Location Address City Name:
FORT CAMPBELL
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-956-0100
Provider Business Practice Location Address Fax Number:
270-956-0124
Provider Enumeration Date:
07/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WC1500X , with the licence number:  RN094527 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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