Provider Demographics
NPI:1922592914
Name:GOEDEL, ANDREA M (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:M
Last Name:GOEDEL
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:740-845-6735
Mailing Address - Fax:740-845-6736
Practice Address - Street 1:371 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-9326
Practice Address - Country:US
Practice Address - Phone:740-845-6735
Practice Address - Fax:740-845-6736
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022838363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily