Provider Demographics
NPI:1275171803
Name:HERBERT, ANDREA ROSE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ROSE
Last Name:HERBERT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:ROSE
Other - Last Name:SCARPELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:7048 TWIN CREEKS CT
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5425
Mailing Address - Country:US
Mailing Address - Phone:440-387-8242
Mailing Address - Fax:
Practice Address - Street 1:4503 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44134-1009
Practice Address - Country:US
Practice Address - Phone:216-398-0349
Practice Address - Fax:216-398-0529
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.025830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily