Provider Demographics
NPI:1912193020
Name:GUNTHER, ANDREA SUE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:SUE
Last Name:GUNTHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:SUE
Other - Last Name:BURDICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:285 CASTLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHERBURNE
Mailing Address - State:NY
Mailing Address - Zip Code:13460-4720
Mailing Address - Country:US
Mailing Address - Phone:315-691-2555
Mailing Address - Fax:
Practice Address - Street 1:285 CASTLE HILL RD
Practice Address - Street 2:
Practice Address - City:SHERBURNE
Practice Address - State:NY
Practice Address - Zip Code:13460-4720
Practice Address - Country:US
Practice Address - Phone:315-691-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4067641163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02112816Medicaid