Basic Information
| Provider Information | |||||||||
| NPI: | 1659670354 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES-ADAMCZYK | ||||||||
| FirstName: | ADRIENNE | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 843225 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641843225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8132628160 | ||||||||
| FaxNumber: | 8138919066 | ||||||||
| Practice Location | |||||||||
| Address1: | 3004 GORDONVILLE RD | ||||||||
| Address2: | |||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637035008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733321972 | ||||||||
| FaxNumber: | 5733344667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2011 | ||||||||
| LastUpdateDate: | 10/14/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | 2010041397 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
ID Information
| ID | Type | State | Issuer | Description | 187382758 | 05 | AR | MEDICAID | 1659670354 | 05 | MO | MEDICAID | 1659670354 | 05 | IL | MEDICAID |