Provider Demographics
NPI:1154131993
Name:GORDHAMER, ANDREA E (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:E
Last Name:GORDHAMER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 HODGE ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-4321
Mailing Address - Country:US
Mailing Address - Phone:903-885-2911
Mailing Address - Fax:
Practice Address - Street 1:106 HODGE ST
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-4321
Practice Address - Country:US
Practice Address - Phone:903-885-2911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1158680363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily