Provider Demographics
NPI:1588073639
Name:ADAMS, MISTY DAWN CONATSER (APRN)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:DAWN CONATSER
Last Name:ADAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:D
Other - Last Name:CONATSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:WHITESBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41858-0040
Mailing Address - Country:US
Mailing Address - Phone:606-633-4823
Mailing Address - Fax:
Practice Address - Street 1:226 MEDICAL PLAZA LN
Practice Address - Street 2:
Practice Address - City:WHITESBURG
Practice Address - State:KY
Practice Address - Zip Code:41858-7425
Practice Address - Country:US
Practice Address - Phone:606-633-4871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008821363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily