Provider Demographics
NPI:1891958278
Name:TARRANCE, ANDREA RENEE (PA)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:RENEE
Last Name:TARRANCE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:424 SE LANCELOT LN
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-6392
Mailing Address - Country:US
Mailing Address - Phone:580-458-2134
Mailing Address - Fax:580-458-2314
Practice Address - Street 1:3009 NW WILSON ST
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-9042
Practice Address - Country:US
Practice Address - Phone:580-458-2134
Practice Address - Fax:580-458-2314
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant