Provider Demographics
NPI:1073356382
Name:ADAMS, JOAN AMETHA
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:AMETHA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 SUITLAND RD APT 910
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-1918
Mailing Address - Country:US
Mailing Address - Phone:240-539-2664
Mailing Address - Fax:
Practice Address - Street 1:3901 SUITLAND RD APT 910
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-1918
Practice Address - Country:US
Practice Address - Phone:240-539-2664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC$$$$$$$$$163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health