Healthcare Provider Details

I. General information

NPI: 1124281845
Provider Name (Legal Business Name): ANDREA JENNINGS STRATHMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA LYNN JENNINGS

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 09/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WAKE FOREST BAPTIST MEDICAL CENTER, PHYSICIAN SERVICES MEDICAL CENTER BLVD
WINSTON SALEM NC
27157-9428
US

IV. Provider business mailing address

MEDICAL CENTER BLVD WAKE FOREST BAPTIST MEDICAL CENTER, PHYSICIAN SERVICES
WINSTON SALEM NC
27157-9428
US

V. Phone/Fax

Practice location:
  • Phone: 913-314-1947
  • Fax:
Mailing address:
  • Phone: 913-314-1947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number148833
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number2012-01470
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: