Clarence Lee Adams Jr., RN

Individual provider Active NPI Administrator Registered Nurse · Duluth, GA

NPI 1598812166 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1598812166
Entity type
Individual (NPI type 1)
Primary specialty
Administrator Registered Nurse 163WA2000X
License
RN146216 (GA)
Practice address
10670 Medlock Bridge Rd
Duluth, GA 30097-8404
Phone
(770) 814-0323
NPI assigned
Jan 4, 2007
Sex
Male
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

LicenseStateTypeSpecialty
RN146216GAMDAdministrator Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X RN146216 GA Yes

Addresses

Primary practice location

10670 Medlock Bridge Rd
Duluth, GA 30097-8404

Mailing address

155 Thistlewood LN
Roswell, GA 30075-2343
Phone (770) 645-0652

Other providers in Duluth, GA

All providers in Duluth, GA · Administrator Registered Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.