Provider Demographics
NPI:1669783643
Name:CHRISMAN, ANDREA NOEL (APRN-NP)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:NOEL
Last Name:CHRISMAN
Suffix:
Gender:F
Credentials:APRN-NP
Other - Prefix:MISS
Other - First Name:ANDREA
Other - Middle Name:NOEL
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:418 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4045
Mailing Address - Country:US
Mailing Address - Phone:308-384-9300
Mailing Address - Fax:308-384-4542
Practice Address - Street 1:418 N WEBB RD
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4045
Practice Address - Country:US
Practice Address - Phone:308-384-9300
Practice Address - Fax:308-384-4542
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111130363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner