Kathleen Ann Adams, RN, IBCLC
Individual provider Active NPI Specialist · Broken Arrow, OK
NPI 1265696223 · NPPES record last updated Jul 17, 2008
Key facts
- NPI
- 1265696223
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- R0045554 (OK)
- Practice address
- 7303 S Oak PL
Broken Arrow, OK 74011-5804 - Phone
- (918) 449-8077
- NPI assigned
- Jul 17, 2008
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0045554 | OK | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | R0045554 | OK | Yes |
Addresses
Primary practice location
7303 S Oak PL
Broken Arrow, OK 74011-5804
Mailing address
7303 S Oak PL
Broken Arrow, OK 74011-5804
Phone (918) 449-8077
Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2008. 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.