Provider Demographics
NPI:1841659927
Name:MCLARTY, ANDREA ELISE (NP (RN MSN NP))
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ELISE
Last Name:MCLARTY
Suffix:
Gender:F
Credentials:NP (RN MSN NP)
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:ELISE
Other - Last Name:SCHETTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP (RN MSN NP)
Mailing Address - Street 1:2305 DE LA VINA STREET
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105
Mailing Address - Country:US
Mailing Address - Phone:805-682-5852
Mailing Address - Fax:
Practice Address - Street 1:2305 DE LA VINA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3873
Practice Address - Country:US
Practice Address - Phone:805-682-5852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17260363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner