Provider Demographics
NPI:1457900904
Name:CUMMINGS, ANDREA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:CUMMINGS
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 1:3200 COLORADO BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6876
Mailing Address - Country:US
Mailing Address - Phone:940-600-5311
Mailing Address - Fax:
Practice Address - Street 1:3200 COLORADO BLVD STE 202
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6876
Practice Address - Country:US
Practice Address - Phone:940-600-5311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-07
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY740843163WG0000X
TX1108183363LF0000X, 207Q00000X
NYF344582-01363LF0000X
FL11010457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily