Provider Demographics
NPI:1982090239
Name:READER, ANDREA SUE (MS, RN, CNS)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:SUE
Last Name:READER
Suffix:
Gender:F
Credentials:MS, RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14616 LEE ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-8877
Mailing Address - Country:US
Mailing Address - Phone:219-798-7650
Mailing Address - Fax:
Practice Address - Street 1:801 MACARTHUR BLVD STE 405
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2919
Practice Address - Country:US
Practice Address - Phone:219-836-5167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041368004364SA2100X
IN28152906A364SA2100X
IN71006980A364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care