Provider Demographics
NPI:1154060291
Name:MUSALLAM, ADRIANNA BASEM (FNP)
Entity type:Individual
Prefix:DR
First Name:ADRIANNA
Middle Name:BASEM
Last Name:MUSALLAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WINDING WOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-4493
Mailing Address - Country:US
Mailing Address - Phone:919-553-1911
Mailing Address - Fax:919-553-3993
Practice Address - Street 1:101 WINDING WOOD DR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-4493
Practice Address - Country:US
Practice Address - Phone:919-553-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016158363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner