Individual
ANDREA WOODGEARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
932 WINDSOR LAKE DR, FORT WAYNE, IN 46845-2045
(419) 630-8106
Mailing address
932 WINDSOR LAKE DR, FORT WAYNE, IN 46845-2045
(419) 630-8106
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006629A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71006629A
INDIANA BOARD OF NURSING APN PRESCRIPTIVE AUTHORITY
IN
01
—
71006629B
INDIANA BOARD OF NURSING CONTROLLED SUBSTANCE REGISTRATION
IN
Enumeration date
10/13/2016
Last updated
05/05/2021
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