Basic Information
| Provider Information | |||||||||
| NPI: | 1710213665 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | LYNNE | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3554 BETTY JEAN LN | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478051088 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8125148125 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2723 S 7TH ST | ||||||||
| Address2: | ST O | ||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122321418 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2009 | ||||||||
| LastUpdateDate: | 07/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 71003102A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 200966270 | 05 | IN | MEDICAID | P00792416 | 01 | IN | RAILROAD MEDICARE | OTHER |