Provider Demographics
NPI:1306856414
Name:NOKES, ANDREA LEANN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEANN
Last Name:NOKES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:LEANN
Other - Last Name:MAXWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 ENGLAND DR
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-0924
Mailing Address - Country:US
Mailing Address - Phone:931-528-7531
Mailing Address - Fax:
Practice Address - Street 1:1401 SPARTA ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-1301
Practice Address - Country:US
Practice Address - Phone:931-473-8468
Practice Address - Fax:931-473-0595
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011905363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNTN0101OtherAMERICHOICE
TN01032615OtherAMERIGROUP
TNQ68311Medicare UPIN
TN3643072Medicare PIN