Provider Demographics
NPI:1235883232
Name:PHAN, ANDREA ROSE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:ROSE
Last Name:PHAN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-1938
Mailing Address - Country:US
Mailing Address - Phone:812-426-2841
Mailing Address - Fax:
Practice Address - Street 1:816 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1938
Practice Address - Country:US
Practice Address - Phone:812-426-2841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28184893A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily