Provider Demographics
NPI:1124980651
Name:HARRISON, ANDREA K
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:K
Last Name:HARRISON
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 1:1025 S 1200 W
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:IN
Mailing Address - Zip Code:46540-9349
Mailing Address - Country:US
Mailing Address - Phone:260-479-8015
Mailing Address - Fax:
Practice Address - Street 1:1025 S 1200 W
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:IN
Practice Address - Zip Code:46540-9349
Practice Address - Country:US
Practice Address - Phone:260-479-8015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach