Provider Demographics
NPI:1386004893
Name:MALONEY, ANDREA D (RN, CCM)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:D
Last Name:MALONEY
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BAY CIR S
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-1942
Mailing Address - Country:US
Mailing Address - Phone:302-423-4686
Mailing Address - Fax:
Practice Address - Street 1:31 BAY CIR S
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-1942
Practice Address - Country:US
Practice Address - Phone:302-423-4686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0046539163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse