Provider Demographics
NPI:1922240340
Name:ANDRIES, MARTHA KATHRYN (MSN, APRN, ANP-BC)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:KATHRYN
Last Name:ANDRIES
Suffix:
Gender:F
Credentials:MSN, APRN, ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 DULLES DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3718
Mailing Address - Country:US
Mailing Address - Phone:337-981-9295
Mailing Address - Fax:337-981-9296
Practice Address - Street 1:1509 DULLES DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-3718
Practice Address - Country:US
Practice Address - Phone:337-981-9295
Practice Address - Fax:337-981-9296
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05759363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health