Provider Demographics
NPI:1528802915
Name:FETTES, ANDREW TODD (RN)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:TODD
Last Name:FETTES
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 REUNION PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-6881
Mailing Address - Country:US
Mailing Address - Phone:919-614-4770
Mailing Address - Fax:
Practice Address - Street 1:124 E GATE CITY BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-1457
Practice Address - Country:US
Practice Address - Phone:336-375-9232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC321256163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine