Provider Demographics
NPI:1962005231
Name:ADAMS, ANNE SPICER (PA-C)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:SPICER
Last Name:ADAMS
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 GORDON GUTMANN BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVLLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3766
Mailing Address - Country:US
Mailing Address - Phone:812-282-6114
Mailing Address - Fax:
Practice Address - Street 1:301 GORDON GUTMANN BLVD STE 201
Practice Address - Street 2:
Practice Address - City:JEFFERSONVLLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3766
Practice Address - Country:US
Practice Address - Phone:812-282-6114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTC116363A00000X
IN10004188A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant