Provider Demographics
NPI:1457639296
Name:RABE, ANDREA NICOLE (APRN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:RABE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4503 2ND AVE
Mailing Address - Street 2:STE. 209 P.O. BOX 338
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-2432
Mailing Address - Country:US
Mailing Address - Phone:308-234-9140
Mailing Address - Fax:308-236-5814
Practice Address - Street 1:4503 2ND AVE
Practice Address - Street 2:STE. 209
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2432
Practice Address - Country:US
Practice Address - Phone:308-234-9140
Practice Address - Fax:308-236-5814
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111093363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health