Provider Demographics
NPI:1386208924
Name:ESTRADA SILLER, ANDREA HAYDEN (MSN, APRN, FNP-C,CPN)
Entity Type:Individual
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First Name:ANDREA
Middle Name:HAYDEN
Last Name:ESTRADA SILLER
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Gender:F
Credentials:MSN, APRN, FNP-C,CPN
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:561-570-5172
Mailing Address - Fax:786-472-5770
Practice Address - Street 1:5920 FM 78
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-5158
Practice Address - Country:US
Practice Address - Phone:210-662-0076
Practice Address - Fax:210-396-7021
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX740547163W00000X
TXAP144353363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1386208924Medicaid