Provider Demographics
NPI:1528611159
Name:ADAMS-INMAN, PHYLLIS MARIE (RN)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:MARIE
Last Name:ADAMS-INMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:PHYLLIS
Other - Middle Name:MARIE
Other - Last Name:ADAMS-INMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1870 STATE HIGHWAY 8
Mailing Address - Street 2:
Mailing Address - City:MOUNT UPTON
Mailing Address - State:NY
Mailing Address - Zip Code:13809-4211
Mailing Address - Country:US
Mailing Address - Phone:607-316-4800
Mailing Address - Fax:
Practice Address - Street 1:693 STATE HIGHWAY 51
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13776-1104
Practice Address - Country:US
Practice Address - Phone:607-783-2207
Practice Address - Fax:607-783-2254
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY534007163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse