Provider Demographics
NPI:1275824393
Name:KEAN, ANDREA MAGRI (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MAGRI
Last Name:KEAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:MAGRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1595 HARSTON AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-6701
Mailing Address - Country:US
Mailing Address - Phone:434-466-3190
Mailing Address - Fax:
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-7846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-23
Last Update Date:2011-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001186888163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse