Provider Demographics
NPI:1417753070
Name:WEST, ANDREA (ABO NCLE)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WEST
Suffix:
Gender:
Credentials:ABO NCLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-3866
Mailing Address - Country:US
Mailing Address - Phone:402-910-9503
Mailing Address - Fax:
Practice Address - Street 1:818 E 23RD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-3866
Practice Address - Country:US
Practice Address - Phone:402-564-0474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician