Provider Demographics
NPI:1083115992
Name:BARBER, ANDREA RENEE (CRNP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:RENEE
Last Name:BARBER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:RENEE
Other - Last Name:YASKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:575 COAL VALLEY RD STE 464
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3740
Mailing Address - Country:US
Mailing Address - Phone:412-267-6360
Mailing Address - Fax:412-267-6361
Practice Address - Street 1:575 COAL VALLEY RD STE 464
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-3740
Practice Address - Country:US
Practice Address - Phone:412-267-6360
Practice Address - Fax:412-267-6361
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-26
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018630363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103492969Medicaid
14212333OtherCAQH