Provider Demographics
NPI:1164559118
Name:ANDREW, CAROLINE E MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:E MARIE
Last Name:ANDREW
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ATWELL RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1394
Mailing Address - Country:US
Mailing Address - Phone:607-547-3456
Mailing Address - Fax:
Practice Address - Street 1:291 MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURGH
Practice Address - State:NY
Practice Address - Zip Code:12122-6520
Practice Address - Country:US
Practice Address - Phone:518-827-3600
Practice Address - Fax:518-827-5544
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY352402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
008525OtherKAISER-COMMERCIAL NUMBER
CO55984215Medicaid
COCK10860Medicare PIN
008525OtherKAISER-COMMERCIAL NUMBER