Provider Demographics
NPI:1386817971
Name:ANDRE, VICKIE LESTER (RN, ARNP, FNP)
Entity Type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:LESTER
Last Name:ANDRE
Suffix:
Gender:F
Credentials:RN, ARNP, FNP
Other - Prefix:MS
Other - First Name:VICKIE
Other - Middle Name:L
Other - Last Name:ANDRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP,FNP
Mailing Address - Street 1:3708 E PEACH TREE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-8909
Mailing Address - Country:US
Mailing Address - Phone:480-895-5875
Mailing Address - Fax:
Practice Address - Street 1:3708 E PEACH TREE DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-8909
Practice Address - Country:US
Practice Address - Phone:480-895-5875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN063153363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner