Individual
ANDRIA JEAN HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2115 N KANSAS AVE, CHILDREN & ADOLESCENT CLINIC PC, HASTINGS, NE 68901
(402) 463-6828
(402) 463-4767
Mailing address
2115 N KANSAS AVE, CHILDREN & ADOLESCENT CLINIC PC, HASTINGS, NE 68901
(402) 463-6828
(402) 463-4767
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1317
NE
363A00000X
Physician Assistant
01493
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47063717813
—
NE
Enumeration date
08/12/2005
Last updated
07/24/2007
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