Provider Demographics
NPI:1861416836
Name:MESSEL, ANDREA DAWN (ARNP CNM)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:DAWN
Last Name:MESSEL
Suffix:
Gender:F
Credentials:ARNP CNM
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:BACH
Other - Last Name:MESSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP CNM
Mailing Address - Street 1:661 E ALTAMONTE DR
Mailing Address - Street 2:SUITE 318
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5105
Mailing Address - Country:US
Mailing Address - Phone:407-303-5204
Mailing Address - Fax:
Practice Address - Street 1:661 E ALTAMONTE DR
Practice Address - Street 2:SUITE 318
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5105
Practice Address - Country:US
Practice Address - Phone:407-303-5204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2208662367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY075EOtherBCBS
FL306621500Medicaid
FLY075EOtherBCBS