Provider Demographics
NPI:1164488474
Name:ADAMS, DIANNA (ARNP)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7380 TURFWAY RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1355
Mailing Address - Country:US
Mailing Address - Phone:859-212-4600
Mailing Address - Fax:859-212-4605
Practice Address - Street 1:7380 TURFWAY ROAD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042
Practice Address - Country:US
Practice Address - Phone:859-962-4600
Practice Address - Fax:859-962-4605
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2386P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2392610Medicaid
KY78009651Medicaid
OHP00001315Medicare PIN
KY78009651Medicaid
P86075Medicare UPIN