Provider Demographics
NPI:1740014919
Name:ELSWICK, ANDREA MARIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:ELSWICK
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 1:2844 LIVERNOIS RD UNIT 99153
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-7423
Mailing Address - Country:US
Mailing Address - Phone:810-531-5060
Mailing Address - Fax:
Practice Address - Street 1:2844 LIVERNOIS RD UNIT 99153
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48099-7423
Practice Address - Country:US
Practice Address - Phone:810-531-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704259092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily