Provider Demographics
NPI:1396308375
Name:AFONYA, ADONYE T (APRN)
Entity type:Individual
Prefix:
First Name:ADONYE
Middle Name:T
Last Name:AFONYA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 ELTON HILLS DR NW STE 201
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2989
Mailing Address - Country:US
Mailing Address - Phone:507-322-6564
Mailing Address - Fax:
Practice Address - Street 1:315 ELTON HILLS DR NW STE 201
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2989
Practice Address - Country:US
Practice Address - Phone:507-322-6564
Practice Address - Fax:507-322-6566
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6536363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health