Basic Information
Provider Information
NPI: 1427613165
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: ASHLEY
MiddleName: HILL
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 101 HARRIS INDUSTRIAL BLVD STE C
Address2:  
City: VIDALIA
State: GA
PostalCode: 304748852
CountryCode: US
TelephoneNumber: 9125371014
FaxNumber:  
Practice Location
Address1: 101 HARRIS INDUSTRIAL BLVD STE C
Address2:  
City: VIDALIA
State: GA
PostalCode: 304748852
CountryCode: US
TelephoneNumber: 9125371014
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/08/2019
LastUpdateDate: 05/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XRN203213GAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363L00000XRN203213GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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