Provider Demographics
NPI:1821420423
Name:OLIVEIRA, ANDREA (RN)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:OLIVEIRA
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 1:14 MIRIJO RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-3825
Mailing Address - Country:US
Mailing Address - Phone:203-797-0395
Mailing Address - Fax:
Practice Address - Street 1:USA MEDDAC BAVARIA
Practice Address - Street 2:CMR 411, BLDG 700, ROSE BARRACKS
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09112-0038
Practice Address - Country:US
Practice Address - Phone:49966-283-4719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT085379163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADOOMedicare UPIN