Provider Demographics
NPI:1265982235
Name:ANDREWS, ANCY (NP-C)
Entity type:Individual
Prefix:
First Name:ANCY
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6894 MULBERRY LN
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-8737
Mailing Address - Country:US
Mailing Address - Phone:727-255-4761
Mailing Address - Fax:
Practice Address - Street 1:2270 JOLLY OAK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3542
Practice Address - Country:US
Practice Address - Phone:517-349-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704262368363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health