Provider Demographics
NPI:1477987188
Name:ANDARY, ALMETA M (FNP)
Entity type:Individual
Prefix:MRS
First Name:ALMETA
Middle Name:M
Last Name:ANDARY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:ALMETA
Other - Middle Name:MYRTICE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, FNP-C
Mailing Address - Street 1:22341 WEST EIGHT MILE RD
Mailing Address - Street 2:SUITE #4
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219
Mailing Address - Country:US
Mailing Address - Phone:313-421-6643
Mailing Address - Fax:313-372-5509
Practice Address - Street 1:11180 GRATIOT AVE
Practice Address - Street 2:SUITE C
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-1363
Practice Address - Country:US
Practice Address - Phone:313-372-7111
Practice Address - Fax:313-372-5509
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704261320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily