Healthcare Provider Details

I. General information

NPI: 1255265229
Provider Name (Legal Business Name): ANDREA HARTER RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 RICHMOND AVE
BATAVIA NY
14020-1227
US

IV. Provider business mailing address

18 CLARK ST
PERRY NY
14530-1104
US

V. Phone/Fax

Practice location:
  • Phone: 585-297-9929
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WI0600X
TaxonomyInfection Control Registered Nurse
License Number771927-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: