Basic Information
Provider Information
NPI: 1801196175
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANDREWS
FirstName: MARIA
MiddleName: ANTONIETA
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 130 SUTTER ST FL 2
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941044009
CountryCode: US
TelephoneNumber: 4156586791
FaxNumber: 4155200904
Practice Location
Address1: 2201 E CAMELBACK RD STE 101A
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850163495
CountryCode: US
TelephoneNumber: 6022184075
FaxNumber: 6022184076
Other Information
ProviderEnumerationDate: 11/02/2010
LastUpdateDate: 10/05/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAP3840AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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