Provider Demographics
NPI:1366854598
Name:ANDREWS, FHTEACHIA MICHELLE (ARNP, NP-C)
Entity Type:Individual
Prefix:
First Name:FHTEACHIA
Middle Name:MICHELLE
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:ARNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 REBECCA LN STE 107
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8350
Mailing Address - Country:US
Mailing Address - Phone:386-775-0736
Mailing Address - Fax:386-775-0738
Practice Address - Street 1:2725 REBECCA LN STE 107
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8350
Practice Address - Country:US
Practice Address - Phone:386-775-0736
Practice Address - Fax:386-775-0738
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9454635363L00000X
NJ26NJ00496800363LF0000X
FLARNP 9454635363LF0000X
FLARNP9454635363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLJDVTAOtherFLORIDA BLUE