Healthcare Provider Details

I. General information

NPI: 1194009332
Provider Name (Legal Business Name): SUSAN ANN ANDREWS RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 10/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LEO MOSS DR CATTARAUGUS COUNTY HEALTH DEPARTMENT
OLEAN NY
14760-1100
US

IV. Provider business mailing address

1 LEO MOSS DR CATTARAUGUS COUNTY HEALTH DEPARTMENT
OLEAN NY
14760-1100
US

V. Phone/Fax

Practice location:
  • Phone: 716-701-3438
  • Fax: 716-701-3744
Mailing address:
  • Phone: 716-701-3438
  • Fax: 716-701-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number333626
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number308713
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: