Individual
ANDREA M MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7500 STATE RD, CINCINNATI, OH 45255-2439
(859) 341-7246
(859) 341-7867
Mailing address
20 MEDICAL VILLAGE DR, SUITE 258, EDGEWOOD, KY 41017-5401
(859) 341-7246
(859) 341-7867
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
128871
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000277556
ANTHEM BCBS
—
05
—
200380670
—
IN
05
—
2092257
—
OH
01
—
617595
WELLCARE
KY
01
—
728033
BUCKEYE
—
05
—
74006487
—
KY
Enumeration date
12/15/2005
Last updated
11/08/2011
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