Provider Demographics
NPI:1427754290
Name:ANDREASEN, HALEIGH LILLIAN (FNP)
Entity type:Individual
Prefix:
First Name:HALEIGH
Middle Name:LILLIAN
Last Name:ANDREASEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 CURTIS BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT JOHN
Mailing Address - State:FL
Mailing Address - Zip Code:32927-3962
Mailing Address - Country:US
Mailing Address - Phone:321-633-5500
Mailing Address - Fax:
Practice Address - Street 1:3740 CURTIS BLVD STE 108
Practice Address - Street 2:
Practice Address - City:PORT SAINT JOHN
Practice Address - State:FL
Practice Address - Zip Code:32927-3962
Practice Address - Country:US
Practice Address - Phone:321-633-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-03
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2022063132363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily