Provider Demographics
NPI:1265981534
Name:EDEN, ANDREW (CRNP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:EDEN
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 N DEAN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-9440
Mailing Address - Country:US
Mailing Address - Phone:334-501-2005
Mailing Address - Fax:877-679-7743
Practice Address - Street 1:890 N DEAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-9440
Practice Address - Country:US
Practice Address - Phone:334-501-2005
Practice Address - Fax:877-679-7743
Is Sole Proprietor?:No
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-140631363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily