Provider Demographics
NPI:1437463023
Name:ANDREWS, TRISTA (LPN)
Entity Type:Individual
Prefix:MS
First Name:TRISTA
Middle Name:
Last Name:ANDREWS
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 1:560 MOUNTAIN LION DR
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:OH
Mailing Address - Zip Code:44050-8804
Mailing Address - Country:US
Mailing Address - Phone:216-559-1234
Mailing Address - Fax:
Practice Address - Street 1:560 MOUNTAIN LION DR
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:OH
Practice Address - Zip Code:44050-8804
Practice Address - Country:US
Practice Address - Phone:216-559-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.132368-M-IV374T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel