Provider Demographics
NPI:1811498835
Name:NESTEBY, ANDREA KRISTINE (PA-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:KRISTINE
Last Name:NESTEBY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 W TUDOR RD STE 5
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-6649
Mailing Address - Country:US
Mailing Address - Phone:907-743-0050
Mailing Address - Fax:907-743-0060
Practice Address - Street 1:510 W TUDOR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6649
Practice Address - Country:US
Practice Address - Phone:907-743-0050
Practice Address - Fax:907-743-0060
Is Sole Proprietor?:No
Enumeration Date:2018-02-25
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
129914363A00000X
AK129914363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant