Individual provider · NPI-1

Andrea Lea Etheridge, CRNA

Nurse Anesthetist, Certified Registered · Bryan, TX

NPI number1346585973
StatusActive
Last updated in NPPESDec 8, 2012

Details

NPI
1346585973
Entity type
Individual (NPI-1)
Name
Andrea Lea Etheridge
Credential
CRNA
Sex
Female
Sole proprietor
No
Enumeration date
Dec 8, 2012
Last updated
Dec 8, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered728571TXYes

Practice location

1737 Briarcrest Dr
Suite 14
Bryan, TX 77802-2769

Phone 214-300-8179

Mailing address

1737 Briarcrest Dr
Suite 14
Bryan, TX 77802-2769

Phone 214-300-8179

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