Provider Demographics
NPI:1851554794
Name:BORGEN, ANDREA MARIE (CDM,CPM)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:MARIE
Last Name:BORGEN
Suffix:
Gender:F
Credentials:CDM,CPM
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:STIERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:154 W MARYDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7501
Mailing Address - Country:US
Mailing Address - Phone:907-262-9446
Mailing Address - Fax:907-262-9354
Practice Address - Street 1:154 W MARYDALE AVE
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7501
Practice Address - Country:US
Practice Address - Phone:907-262-9446
Practice Address - Fax:907-262-9354
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK56176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife