Individual
MS. ANDREA VENUS DAVIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4320 FIR ST UNIT 313, EAST CHICAGO, IN 46312-3078
(219) 392-7424
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28180308A
IN
363L00000X
Nurse Practitioner
Primary
71009851A
IN
Other
Enumeration date
12/05/2019
Last updated
07/09/2020
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