Provider Demographics
NPI:1295903847
Name:ESU, ANDREA DENISE (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:DENISE
Last Name:ESU
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8136 APPOLINE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-4002
Mailing Address - Country:US
Mailing Address - Phone:313-610-1101
Mailing Address - Fax:313-934-8274
Practice Address - Street 1:5555 CONNER ST
Practice Address - Street 2:SUITE 1000, SOUTH
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-3448
Practice Address - Country:US
Practice Address - Phone:313-347-2064
Practice Address - Fax:313-579-1819
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704182323163WA0400X, 163WC0400X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC0400XNursing Service ProvidersRegistered NurseCase Management