Individual
MS. ANDREA Y PROVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
30 CAMPUS RD, ANNANDALE ON HUDSON, NY 12504-9800
(845) 758-7433
(845) 758-7437
Mailing address
4663 ROUTE 9G, GERMANTOWN, NY 12526-5128
(518) 537-7678
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
331217
NY
Other
Enumeration date
05/01/2006
Last updated
06/27/2023
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