Provider Demographics
NPI:1902392087
Name:ADAMS, AYESHA JERE
Entity Type:Individual
Prefix:
First Name:AYESHA
Middle Name:JERE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5311 S CLOVERDALE LN
Mailing Address - Street 2:
Mailing Address - City:BATTLEFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65619-9691
Mailing Address - Country:US
Mailing Address - Phone:417-365-6085
Mailing Address - Fax:
Practice Address - Street 1:607 E MADISON ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65806-3831
Practice Address - Country:US
Practice Address - Phone:314-629-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide