Provider Demographics
NPI:1699065466
Name:DEAN, ANDREA R (CRNP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:R
Last Name:DEAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 CHAPMAN RD STE 106
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5417
Mailing Address - Country:US
Mailing Address - Phone:484-550-2085
Mailing Address - Fax:
Practice Address - Street 1:256 CHAPMAN RD STE 106
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5417
Practice Address - Country:US
Practice Address - Phone:302-444-4366
Practice Address - Fax:302-861-6197
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011179363L00000X
DELP-0000220363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner