Provider Demographics
NPI:1336684075
Name:THUDE, ANDREAS JOHANES (FNP)
Entity Type:Individual
Prefix:MR
First Name:ANDREAS
Middle Name:JOHANES
Last Name:THUDE
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 N CLANTON ST
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85396-7703
Mailing Address - Country:US
Mailing Address - Phone:623-201-9930
Mailing Address - Fax:
Practice Address - Street 1:26700 S US HIGHWAY 85
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-5024
Practice Address - Country:US
Practice Address - Phone:623-386-6160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9684363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily