Provider Demographics
NPI:1104298272
Name:BELT, ANDREA (APRN)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:BELT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 EMORY VALLEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-7762
Mailing Address - Country:US
Mailing Address - Phone:865-296-9210
Mailing Address - Fax:
Practice Address - Street 1:665 EMORY VALLEY RD STE B
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7762
Practice Address - Country:US
Practice Address - Phone:865-296-9210
Practice Address - Fax:865-272-3294
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN206403163W00000X
TN27068363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse