Provider Demographics
NPI:1518254366
Name:WESTMORELAND, ADRIANNE DENISE (DO)
Entity type:Individual
Prefix:DR
First Name:ADRIANNE
Middle Name:DENISE
Last Name:WESTMORELAND
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7631 145TH ST W STE 110
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-5530
Mailing Address - Country:US
Mailing Address - Phone:612-455-0817
Mailing Address - Fax:
Practice Address - Street 1:7631 145TH ST W STE 110
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-5530
Practice Address - Country:US
Practice Address - Phone:612-455-0817
Practice Address - Fax:833-450-5972
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5932207Q00000X
AZ11239207Q00000X
COCDR.0004245207Q00000X
WI3035-321207Q00000X
SC1490207Q00000X
IADO-04903207Q00000X
MN63662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC014905Medicaid
SCSC1034D984Medicare PIN
SCSC10347108Medicare PIN