1588176069 NPI number — ADRIAN CADE APRN

Table of content: ADRIAN CADE APRN (NPI 1588176069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588176069 NPI number — ADRIAN CADE APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CADE
Provider First Name:
ADRIAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
M

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:
1588176069
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/28/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6265 ROCK CHALK DR STE 1100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWRENCE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66049-5232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-505-5160
Provider Business Mailing Address Fax Number:
785-505-5282

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6265 ROCK CHALK DR STE 1100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66049-5232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-505-5160
Provider Business Practice Location Address Fax Number:
785-505-5282
Provider Enumeration Date:
10/24/2017

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: 363LF0000X , with the licence number:  5377813072 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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