Provider Demographics
NPI:1588665863
Name:ADAMS, WENJING (CRNA, APRN)
Entity type:Individual
Prefix:
First Name:WENJING
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CRNA, APRN
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA, APRN
Mailing Address - Street 1:11250 OLD SAINT AUGUSTINE RD
Mailing Address - Street 2:UNIT 266
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-1088
Mailing Address - Country:US
Mailing Address - Phone:813-382-0004
Mailing Address - Fax:
Practice Address - Street 1:11250 OLD SAINT AUGUSTINE RD
Practice Address - Street 2:UNIT 266
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-1088
Practice Address - Country:US
Practice Address - Phone:813-382-0004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002981367500000X
FLARNP9314073367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
020981OtherCONNECTICARE
P00199184OtherRAILROAD MEDICARE
400002981CT01OtherBLUE CROSS BLUE SHIELD
2V6470OtherHEALTHNET
Q06996Medicare UPIN
P00199184OtherRAILROAD MEDICARE