Provider Demographics
NPI:1588990386
Name:SMITH, ANDREA G (NP)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:G
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:806 GOVERNORS DR SW STE 206
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5133
Mailing Address - Country:US
Mailing Address - Phone:256-715-4239
Mailing Address - Fax:
Practice Address - Street 1:415 CHURCH ST NW STE 10
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5573
Practice Address - Country:US
Practice Address - Phone:256-536-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2025-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-095819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL115703Medicaid
AL1588990386Medicare PIN