Provider Demographics
NPI:1386233526
Name:PIAZZA, ANDREA K
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:K
Last Name:PIAZZA
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 1:11 MYERS AVE
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1928
Mailing Address - Country:US
Mailing Address - Phone:781-659-1335
Mailing Address - Fax:
Practice Address - Street 1:11 MYERS AVE
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1928
Practice Address - Country:US
Practice Address - Phone:781-659-1335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN261037163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator