Provider Demographics
NPI:1225621956
Name:GARCIA, ANDREA (RN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 296
Mailing Address - Street 2:
Mailing Address - City:PROCTORSVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05153-0296
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 ELM ST
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:VT
Practice Address - Zip Code:05149-1301
Practice Address - Country:US
Practice Address - Phone:802-228-8867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0142549163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management