Provider Demographics
NPI:1750848180
Name:ACHANE, ANDRENITA JANEE
Entity Type:Individual
Prefix:MISS
First Name:ANDRENITA
Middle Name:JANEE
Last Name:ACHANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 COLD RIVER DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4225
Mailing Address - Country:US
Mailing Address - Phone:832-233-0769
Mailing Address - Fax:
Practice Address - Street 1:2135 COLD RIVER DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4225
Practice Address - Country:US
Practice Address - Phone:832-233-0769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer