Basic Information
Provider Information
NPI: 1013674571
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HERSHEY
FirstName: ANDREW
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 858
Address2:  
City: HERSHEY
State: PA
PostalCode: 170330858
CountryCode: US
TelephoneNumber: 8002431455
FaxNumber:  
Practice Location
Address1: 500 UNIVERSITY DR
Address2:  
City: HERSHEY
State: PA
PostalCode: 170332360
CountryCode: US
TelephoneNumber: 7175316597
FaxNumber: 7175317790
Other Information
ProviderEnumerationDate: 11/19/2021
LastUpdateDate: 11/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN661408PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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