Provider Demographics
NPI:1740038587
Name:BALLESTEROS, ANDREA (APRN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BALLESTEROS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E LONG ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-3100
Mailing Address - Country:US
Mailing Address - Phone:775-887-2195
Mailing Address - Fax:
Practice Address - Street 1:900 E LONG ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3100
Practice Address - Country:US
Practice Address - Phone:775-887-2195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN94736363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily