Provider Demographics
NPI:1033200530
Name:SHAH, ANDREA CROSBY (RN, MS, FNP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CROSBY
Last Name:SHAH
Suffix:
Gender:F
Credentials:RN, MS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 POTRERO AVE UNIT 6M
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3518
Mailing Address - Country:US
Mailing Address - Phone:628-206-3501
Mailing Address - Fax:628-206-6900
Practice Address - Street 1:1001 POTRERO AVE UNIT 6M
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:628-206-3501
Practice Address - Fax:628-206-6900
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16786363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily