Provider Demographics
NPI:1518547785
Name:CORDEIRO, DAVID ANDREW (FNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANDREW
Last Name:CORDEIRO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ACUSHNET
Mailing Address - State:MA
Mailing Address - Zip Code:02743-1118
Mailing Address - Country:US
Mailing Address - Phone:508-954-2208
Mailing Address - Fax:
Practice Address - Street 1:4499 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-4707
Practice Address - Country:US
Practice Address - Phone:508-995-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2273347163WC0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care MedicineGroup - Single Specialty