Provider Demographics
NPI:1053428623
Name:ADAMS, MARY E (ARNP)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:E
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
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Mailing Address - Street 1:13503 3RD AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-9538
Mailing Address - Country:US
Mailing Address - Phone:941-545-7111
Mailing Address - Fax:941-545-7111
Practice Address - Street 1:13503 3RD AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-9538
Practice Address - Country:US
Practice Address - Phone:941-545-7111
Practice Address - Fax:941-545-7111
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2013-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL2016472363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308883900Medicaid
7239360OtherAETNA
2042251OtherCIGNA BEHAVIORAL HEALTH
FLY9827OtherBCBS OF FL
600479-206OtherMAGELLAN
2042251OtherCIGNA BEHAVIORAL HEALTH