Provider Demographics
NPI:1386965085
Name:GASPER, ADRIANNE (NP)
Entity type:Individual
Prefix:MRS
First Name:ADRIANNE
Middle Name:
Last Name:GASPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:ADRIANNE
Other - Middle Name:
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1573 W FAIRBANKS AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4679
Mailing Address - Country:US
Mailing Address - Phone:407-303-6729
Mailing Address - Fax:
Practice Address - Street 1:1573 W FAIRBANKS AVE STE 210
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4679
Practice Address - Country:US
Practice Address - Phone:407-303-6729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4526-33363L00000X
IN71003363A363LA2200X
WV4526-33363LP0200X
FLAPRN11007160363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200992450Medicaid
IN262210085OtherMEDICARE PTAN