Provider Demographics
NPI:1649557950
Name:LAMB, ANDREA (NP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2643 PATTERSON RD
Mailing Address - Street 2:SUITE 605
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1936
Mailing Address - Country:US
Mailing Address - Phone:970-298-2482
Mailing Address - Fax:970-298-1701
Practice Address - Street 1:2643 PATTERSON RD
Practice Address - Street 2:SUITE 605
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1936
Practice Address - Country:US
Practice Address - Phone:970-298-2482
Practice Address - Fax:970-298-1701
Is Sole Proprietor?:No
Enumeration Date:2011-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP-990239363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO374992ZGEEMedicare PIN