Provider Demographics
NPI:1598808263
Name:WITT, ANDREA J (CRNA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:J
Last Name:WITT
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:8201 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-4904
Mailing Address - Country:US
Mailing Address - Phone:850-474-8100
Mailing Address - Fax:850-474-8083
Practice Address - Street 1:1000 MAR WALT DR
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-6708
Practice Address - Country:US
Practice Address - Phone:850-474-8100
Practice Address - Fax:850-474-8083
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9256392367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered