Basic Information
Provider Information
NPI: 1972034197
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLNER
FirstName: ADRIENNE
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: UPHOFF
OtherFirstName: ADRIENNE
OtherMiddleName: E
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 680 LIGHTHOUSE AVE UNIT 397
Address2:  
City: PACIFIC GROVE
State: CA
PostalCode: 939508021
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1441 CONSTITUTION BLVD
Address2:  
City: SALINAS
State: CA
PostalCode: 939063100
CountryCode: US
TelephoneNumber: 8317554111
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/21/2017
LastUpdateDate: 05/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207V00000X174105CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home