Provider Demographics
NPI:1215055892
Name:ADKINS, DOROTHY JUANITA (HHA ICP)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:JUANITA
Last Name:ADKINS
Suffix:
Gender:F
Credentials:HHA ICP
Other - Prefix:MISS
Other - First Name:DOROTHY
Other - Middle Name:JUANITA
Other - Last Name:LANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2384 BLUE RUN RD
Mailing Address - Street 2:
Mailing Address - City:LUCASVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45648
Mailing Address - Country:US
Mailing Address - Phone:740-820-5545
Mailing Address - Fax:
Practice Address - Street 1:2384 BLUE RUN RD
Practice Address - Street 2:
Practice Address - City:LUCASVILLE
Practice Address - State:OH
Practice Address - Zip Code:45648
Practice Address - Country:US
Practice Address - Phone:740-820-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide