Provider Demographics
NPI:1760965438
Name:MUNROE-SERVICE, ANDREA NADINE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:NADINE
Last Name:MUNROE-SERVICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8395 W OAKLAND PARK BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7346
Mailing Address - Country:US
Mailing Address - Phone:561-404-1422
Mailing Address - Fax:
Practice Address - Street 1:8395 W OAKLAND PARK BLVD STE C
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7346
Practice Address - Country:US
Practice Address - Phone:561-404-1422
Practice Address - Fax:561-404-1425
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9186730163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)