Provider Demographics
NPI:1407511710
Name:THRASH, ANDREKA (RN)
Entity Type:Individual
Prefix:
First Name:ANDREKA
Middle Name:
Last Name:THRASH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 LEANING PINE CT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31820-4430
Mailing Address - Country:US
Mailing Address - Phone:706-358-1534
Mailing Address - Fax:
Practice Address - Street 1:7777 LEANING PINE CT
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:GA
Practice Address - Zip Code:31820-4430
Practice Address - Country:US
Practice Address - Phone:706-358-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN261589163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty