Provider Demographics
NPI:1164828893
Name:SILZ, ANDREW (CNP)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SILZ
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4995 PEACOCK RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-6719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 LOONEY RD
Practice Address - Street 2:SUITE 201
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-4199
Practice Address - Country:US
Practice Address - Phone:937-773-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.16925-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily