Provider Demographics
NPI:1992289524
Name:NIX, ANDREA NICOLE (NP-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:NIX
Suffix:
Gender:F
Credentials:NP-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1265 N MAIN ST UNIT 503
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-2820
Mailing Address - Country:US
Mailing Address - Phone:317-762-0030
Mailing Address - Fax:317-762-0080
Practice Address - Street 1:70 E MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-4201
Practice Address - Country:US
Practice Address - Phone:317-762-0030
Practice Address - Fax:317-762-0080
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71008638A363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner