Provider Demographics
NPI:1982252433
Name:WELANDER, ANDREA MARIE
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:WELANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4517 STOCKWELL ST APT 1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-4282
Mailing Address - Country:US
Mailing Address - Phone:402-429-8961
Mailing Address - Fax:
Practice Address - Street 1:4517 STOCKWELL ST APT 1
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-4282
Practice Address - Country:US
Practice Address - Phone:402-429-8961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide