Provider Demographics
NPI:1891070678
Name:NYGAARD, ANDREA CLARICE (PHARMD, RPH)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:CLARICE
Last Name:NYGAARD
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6905 KENNEDY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46323
Mailing Address - Country:US
Mailing Address - Phone:219-844-5034
Mailing Address - Fax:
Practice Address - Street 1:6905 KENNEDY AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46323
Practice Address - Country:US
Practice Address - Phone:219-844-5034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26021477A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist