Provider Demographics
NPI:1346594298
Name:WHITCOMB, ANDREA LEIGH (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LEIGH
Last Name:WHITCOMB
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 MUTTS RD
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38572-3236
Mailing Address - Country:US
Mailing Address - Phone:931-510-6646
Mailing Address - Fax:
Practice Address - Street 1:1503 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-5967
Practice Address - Country:US
Practice Address - Phone:931-484-6196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily