Provider Demographics
NPI:1376276097
Name:WEST, ANDREA BEATRICE (PA)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:BEATRICE
Last Name:WEST
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:317-621-7547
Mailing Address - Fax:
Practice Address - Street 1:7979 N SHADELAND AVE STE 310
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-2042
Practice Address - Country:US
Practice Address - Phone:317-887-7968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2023-05-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN10003959A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant