Provider Demographics
NPI:1104697168
Name:BLINDT, ANDREA MARIE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:BLINDT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7022 STARLIGHT CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3543
Mailing Address - Country:US
Mailing Address - Phone:310-612-1839
Mailing Address - Fax:
Practice Address - Street 1:7022 STARLIGHT CIR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3543
Practice Address - Country:US
Practice Address - Phone:310-612-1839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA778136163WC1500X, 163WG0100X, 163WH1000X, 163WI0600X, 163WM0102X, 163WM0705X, 163WN1003X, 163WP0200X, 163WP0218X, 163WP0807X, 163WP0808X, 163WP0809X, 163WR1000X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WP0218XNursing Service ProvidersRegistered NursePediatric Oncology
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/Infertility