Provider Demographics
NPI:1982466785
Name:STREATER, ANDREA C (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:C
Last Name:STREATER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 SOUTHDOWN RD
Mailing Address - Street 2:
Mailing Address - City:LLOYD HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11743-1722
Mailing Address - Country:US
Mailing Address - Phone:617-686-3885
Mailing Address - Fax:
Practice Address - Street 1:239 SOUTHDOWN RD
Practice Address - Street 2:
Practice Address - City:LLOYD HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11743-1722
Practice Address - Country:US
Practice Address - Phone:617-686-3885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF352808-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily