Provider Demographics
NPI:1164689659
Name:GEARING, ANDREA KAY
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:KAY
Last Name:GEARING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 W GROVERS AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3460
Mailing Address - Country:US
Mailing Address - Phone:602-467-5710
Mailing Address - Fax:602-467-5780
Practice Address - Street 1:4701 W GROVERS AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3460
Practice Address - Country:US
Practice Address - Phone:602-467-5710
Practice Address - Fax:602-467-5780
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN092907163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool