Provider Demographics
NPI:1629039490
Name:ANDREWS, MARY FRANCES (NP)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:FRANCES
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:FRANCES
Other - Last Name:TRICKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 34693
Mailing Address - Street 2:BAYFRONT EMERGENCY PHYSICIANS PA
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07189-4963
Mailing Address - Country:US
Mailing Address - Phone:610-668-6491
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:1 E NEW YORK AVE
Practice Address - Street 2:SHORE MEMORIAL HOSPITAL
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244
Practice Address - Country:US
Practice Address - Phone:856-653-3159
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00052400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2644901000OtherAMERIHEALTH
NJ0048984Medicaid
NJ60021506OtherHORIZON NJ HEALTH
Q13930Medicare UPIN
NJ078244Medicare ID - Type Unspecified
NJ2644901000OtherAMERIHEALTH
NJP00387816Medicare PIN