Provider Demographics
NPI:1689755076
Name:ANDRS, KRISTIN MCGRAW (NP)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:MCGRAW
Last Name:ANDRS
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 1:2801 BOULEVARD, SUITE D
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834
Mailing Address - Country:US
Mailing Address - Phone:804-733-3333
Mailing Address - Fax:855-586-3257
Practice Address - Street 1:2801 BOULEVARD, SUITE D
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834
Practice Address - Country:US
Practice Address - Phone:804-733-3333
Practice Address - Fax:855-586-3257
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164391363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010249481 541581185Medicaid
VAC03684Medicare PIN
VA009391M98Medicare PIN
VAP33441Medicare UPIN