Provider Demographics
NPI:1093367716
Name:ESKRIDGE, ANDREA DANETTE (CNM)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:DANETTE
Last Name:ESKRIDGE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1383 HARVARD RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1133
Mailing Address - Country:US
Mailing Address - Phone:248-396-6842
Mailing Address - Fax:
Practice Address - Street 1:22255 GREENFIELD RD STE 352
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3712
Practice Address - Country:US
Practice Address - Phone:248-849-3401
Practice Address - Fax:248-849-4106
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704270840367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife