Provider Demographics
NPI:1679585459
Name:MCRAE, ANDREA LYNN (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYNN
Last Name:MCRAE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ATTN: CREDENTIALS OFFICE
Mailing Address - Street 2:CMR 442
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09042
Mailing Address - Country:DE
Mailing Address - Phone:49622-117-2274
Mailing Address - Fax:49622-117-2941
Practice Address - Street 1:HEIDELBERG MEDDAC
Practice Address - Street 2:CMR 442
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09042
Practice Address - Country:DE
Practice Address - Phone:49622-117-2274
Practice Address - Fax:49622-117-2941
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9175305163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient