Provider Demographics
NPI:1437839297
Name:ANDRADE, ALEXANDRA JORDAN
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:JORDAN
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4437 WHISPERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-1319
Mailing Address - Country:US
Mailing Address - Phone:706-836-3521
Mailing Address - Fax:
Practice Address - Street 1:4437 WHISPERWOOD DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-1319
Practice Address - Country:US
Practice Address - Phone:706-836-3521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical