Provider Demographics
NPI:1639390347
Name:PRITCHARD, ANDREA NICOLE (LPN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:NICOLE
Other - Last Name:GALLION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:389 KENTUCK FRK
Mailing Address - Street 2:
Mailing Address - City:BRANCHLAND
Mailing Address - State:WV
Mailing Address - Zip Code:25506-9640
Mailing Address - Country:US
Mailing Address - Phone:304-778-3481
Mailing Address - Fax:
Practice Address - Street 1:135 4TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-1219
Practice Address - Country:US
Practice Address - Phone:304-526-5691
Practice Address - Fax:304-781-1021
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV27140164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse