Provider Demographics
NPI:1609419985
Name:HOUK, ANDREA LYNN
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:HOUK
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 1:7855 MARRIOTT RD
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:CO
Mailing Address - Zip Code:80809-1726
Mailing Address - Country:US
Mailing Address - Phone:719-473-7808
Mailing Address - Fax:719-473-4877
Practice Address - Street 1:7855 MARRIOTT RD
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:CO
Practice Address - Zip Code:80809-1726
Practice Address - Country:US
Practice Address - Phone:719-473-7808
Practice Address - Fax:719-473-4877
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-19
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0175919163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator