Individual
ANDREA STROTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4930 ILLINOIS RD STE 5, FORT WAYNE, IN 46804-5105
(260) 467-0470
Mailing address
4930 ILLINOIS RD STE 5, FORT WAYNE, IN 46804-5105
(260) 467-0470
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.552389
IL
163W00000X
Registered Nurse
Primary
28183869A
IN
163WC1500X
Community Health Registered Nurse
041.552389
IL
163WC1500X
Community Health Registered Nurse
28183869A
IN
163WH0200X
Home Health Registered Nurse
28183869A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041.552389
ILLINOIS DEPARTMENT FOR PROFESSIONAL REGULATION
IL
Enumeration date
07/17/2023
Last updated
11/22/2023
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