Provider Demographics
NPI:1821427055
Name:GONZALEZ, ANDREA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:HQ SPECIAL OPERATIONS CMD EUR
Mailing Address - Street 2:ATTN: SOHC MAJ ANDREA GONZALEZ
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09131-0400
Mailing Address - Country:US
Mailing Address - Phone:324-379-4042
Mailing Address - Fax:
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:ATTN: CREDENTIALS OFFICE
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-956-8106
Practice Address - Fax:270-256-8106
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2023-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
1115660363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant