Individual
ANDREA ETHEL THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN
Contact information
Practice address
13704 VILLAGE LAKEVIEW AVE., SUITE #250, WINDERMERE, FL 34786
(407) 408-7931
(407) 393-5526
Mailing address
13704 VILLAGE LAKEVIEW AVE., SUITE# 250, WINDERMERE, FL 34786
(407) 408-7931
(407) 393-5526
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
13-94770-092
KS
363L00000X
Nurse Practitioner
Primary
9495387
FL
363LP0200X
Pediatric Nurse Practitioner
53-77278-092
KS
363LP0200X
Pediatric Nurse Practitioner
9495387
FL
Other
Enumeration date
06/30/2014
Last updated
06/06/2024
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