Individual
ANDREA WIRT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222
(409) 772-2222
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-1022
(409) 747-0890
(409) 772-0885
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
530385
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP107005
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041443501
—
TX
Enumeration date
12/08/2006
Last updated
07/30/2019
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