Provider Demographics
NPI:1710740915
Name:VIVIAN, ANDREA DOWELL (CRNP)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:DOWELL
Last Name:VIVIAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 BARRIERTOWN DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:TN
Mailing Address - Zip Code:38372-7003
Mailing Address - Country:US
Mailing Address - Phone:919-608-9738
Mailing Address - Fax:
Practice Address - Street 1:465 BARRIERTOWN DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:TN
Practice Address - Zip Code:38372-7003
Practice Address - Country:US
Practice Address - Phone:919-608-9738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35346363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily