Provider Demographics
NPI:1962175646
Name:ADAMS, JOANNE ROCHELLE (NP-C)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:ROCHELLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 E FLAMINGO AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83687-3102
Mailing Address - Country:US
Mailing Address - Phone:208-442-8035
Mailing Address - Fax:208-442-8038
Practice Address - Street 1:3908 E FLAMINGO AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-3102
Practice Address - Country:US
Practice Address - Phone:208-442-8035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID69108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily