Provider Demographics
NPI:1003279209
Name:HENKEL, ANDREA GRACE (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:GRACE
Last Name:HENKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:GRACE
Other - Last Name:HUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3850 TUNLAW RD NW
Mailing Address - Street 2:APT 507
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-4806
Mailing Address - Country:US
Mailing Address - Phone:651-402-4324
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:650-723-7737
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA151537207VC0300X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VC0300XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyComplex Family Planning
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology