Provider Demographics
NPI: | 1124281845 |
---|---|
Name: | STRATHMAN, ANDREA JENNINGS (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | ANDREA |
Middle Name: | JENNINGS |
Last Name: | STRATHMAN |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | ANDREA |
Other - Middle Name: | LYNN |
Other - Last Name: | JENNINGS |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | |
Mailing Address - Street 1: | MEDICAL CENTER BLVD |
Mailing Address - Street 2: | WAKE FOREST BAPTIST MEDICAL CENTER, PHYSICIAN SERVICES |
Mailing Address - City: | WINSTON SALEM |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27157-9428 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 913-314-1947 |
Mailing Address - Fax: | |
Practice Address - Street 1: | WAKE FOREST BAPTIST MEDICAL CENTER, PHYSICIAN SERVICES |
Practice Address - Street 2: | MEDICAL CENTER BLVD |
Practice Address - City: | WINSTON SALEM |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27157-9428 |
Practice Address - Country: | US |
Practice Address - Phone: | 913-314-1947 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-07-02 |
Last Update Date: | 2017-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 2012-01470 | 207LP2900X |
NC | 148833 | 207L00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | |
No | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |