Provider Demographics
NPI:1326588567
Name:FELEY, ANDREA (RN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:FELEY
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 1:103 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3978
Mailing Address - Country:US
Mailing Address - Phone:517-404-8161
Mailing Address - Fax:
Practice Address - Street 1:103 CRESTVIEW DR
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3978
Practice Address - Country:US
Practice Address - Phone:517-404-8161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41669818163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse