Provider Demographics
NPI:1205379047
Name:KIRBY, ANDREA S (CNP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:S
Last Name:KIRBY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:S
Other - Last Name:PHEIFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5400 FRANTZ RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4144
Mailing Address - Country:US
Mailing Address - Phone:614-544-6382
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:3705 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3467
Practice Address - Country:US
Practice Address - Phone:614-262-6772
Practice Address - Fax:614-533-0161
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.335227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily