Basic Information
| Provider Information | |||||||||
| NPI: | 1700359684 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | DARLENE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 103 SEA OAKS CT | ||||||||
| Address2: | |||||||||
| City: | BYRON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310086449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4783971551 | ||||||||
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| Practice Location | |||||||||
| Address1: | 940 GA HIGHWAY 96 | ||||||||
| Address2: | |||||||||
| City: | WARNER ROBINS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 310882584 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4789881222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2019 | ||||||||
| LastUpdateDate: | 01/03/2019 | ||||||||
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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 | 164W00000X | LPN075235 | GA | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.