Brandy Leticia Adams, BACHELORS IECE
Individual provider Active NPI Specialist · Bowling Green, KY
NPI 1013226679 · NPPES record last updated Sep 30, 2010
Key facts
- NPI
- 1013226679
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 200700812 (KY)
- Practice address
- 349 Brighton Ave
Bowling Green, KY 42101-9087 - Phone
- (859) 319-7616
- NPI assigned
- Sep 30, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 200700812 | KY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 200700812 | KY | Yes |
Addresses
Primary practice location
349 Brighton Ave
Bowling Green, KY 42101-9087
Mailing address
349 Brighton Ave
Bowling Green, KY 42101-9087
Phone (859) 319-7616
Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.