Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 4704257684 | MI |
N | 363LA2200X | Nurse Practitioner - Adult Health | NP14500 | CA |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 4704257684 | MI |
N | 363LP2300X | Nurse Practitioner - Primary Care | NP14500 | CA |
NPI | 1033403118 |
---|---|
Provider Name | Charlotte G Andreasen |
First Address | Battle Creek, MI 49017 |
Second Address | Battle Creek, MI 49017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2011 |
Last Update Date | 06/06/2011 |