Healthcare Provider Details

I. General information

NPI: 1114117736
Provider Name (Legal Business Name): ANDREA JANE EFRE DNP, ARNP, ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2007
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5537 SHELDON RD SUITE A
TAMPA FL
33615-3153
US

IV. Provider business mailing address

5537 SHELDON RD SUITE A
TAMPA FL
33615-3153
US

V. Phone/Fax

Practice location:
  • Phone: 813-503-6206
  • Fax:
Mailing address:
  • Phone: 813-503-6206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2900022
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: