Provider Demographics
NPI:1194481697
Name:ADORN WOMEN'S CLINIC & MEDSPA, LLC
Entity type:Organization
Organization Name:ADORN WOMEN'S CLINIC & MEDSPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ NP
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:602-805-5200
Mailing Address - Street 1:9300 E RAINTREE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-7313
Mailing Address - Country:US
Mailing Address - Phone:602-850-5200
Mailing Address - Fax:
Practice Address - Street 1:9300 E RAINTREE DR STE 130
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-7313
Practice Address - Country:US
Practice Address - Phone:602-850-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1992910541OtherNPI