Provider Demographics
NPI:1831598770
Name:WOOD, ANDREA ROSYLN MONTANARI (AGACNP)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ROSYLN MONTANARI
Last Name:WOOD
Suffix:
Gender:
Credentials:AGACNP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:R
Other - Last Name:MONTANARI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:101 PAGE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3464
Practice Address - Country:US
Practice Address - Phone:508-973-2204
Practice Address - Fax:508-973-2640
Is Sole Proprietor?:No
Enumeration Date:2014-08-16
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN283934363L00000X, 363LC0200X, 363LA2100X
CT5874363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine