Provider Demographics
NPI:1184705337
Name:STOLL, ANDREA GAY (RNFA)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:GAY
Last Name:STOLL
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14536 80TH STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:LOXATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470
Mailing Address - Country:US
Mailing Address - Phone:561-784-0427
Mailing Address - Fax:866-277-6962
Practice Address - Street 1:1128-253 ROYAL PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411
Practice Address - Country:US
Practice Address - Phone:561-784-0427
Practice Address - Fax:866-277-6962
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN3153272163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY037MOtherBLUE CROSS BLUE SHIELD