Individual
ANDREA D DEMARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
95 S LAUREL RD STE 1, LONDON, KY 40744-8300
(606) 770-5086
(863) 456-1301
Mailing address
95 S LAUREL RD STE 1, LONDON, KY 40744-8300
(606) 770-5086
(863) 456-1301
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN0000200386
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
36635
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4025009
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7101023360
—
KY
Enumeration date
12/13/2023
Last updated
01/13/2025
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