Provider Demographics
NPI:1346408515
Name:ADAMSON, GRETTA
Entity type:Individual
Prefix:MRS
First Name:GRETTA
Middle Name:
Last Name:ADAMSON
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 1:546 FALL DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-7607
Mailing Address - Country:US
Mailing Address - Phone:208-467-5927
Mailing Address - Fax:
Practice Address - Street 1:546 FALL DR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-7607
Practice Address - Country:US
Practice Address - Phone:208-467-5927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker