Provider Demographics
NPI:1316242464
Name:GRECO, ANDREA DANETTE (ARNP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:DANETTE
Last Name:GRECO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-4064
Mailing Address - Country:US
Mailing Address - Phone:239-682-3047
Mailing Address - Fax:239-430-0903
Practice Address - Street 1:4575 NORTH RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-4064
Practice Address - Country:US
Practice Address - Phone:239-682-3047
Practice Address - Fax:239-430-0903
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1844072363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health