Provider Demographics
NPI:1396004214
Name:MARKLEY, ANDREA PAULETTE (LPN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:PAULETTE
Last Name:MARKLEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 LAFAYETTE CIR
Mailing Address - Street 2:
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-6101
Mailing Address - Country:US
Mailing Address - Phone:518-694-9907
Mailing Address - Fax:
Practice Address - Street 1:150 BROADWAY STE 310
Practice Address - Street 2:
Practice Address - City:MENANDS
Practice Address - State:NY
Practice Address - Zip Code:12204-2726
Practice Address - Country:US
Practice Address - Phone:518-694-9907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-12
Last Update Date:2012-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303733164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse