Healthcare Provider Details

I. General information

NPI: 1528433992
Provider Name (Legal Business Name): ANDREA M WRIGHT AGPCNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA WEST NP

II. Dates (important events)

Enumeration Date: 12/10/2015
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 AUBURN AVE RM 6166
CINCINNATI OH
45219-2906
US

IV. Provider business mailing address

2139 AUBURN AVE RM 6166
CINCINNATI OH
45219-2906
US

V. Phone/Fax

Practice location:
  • Phone: 513-585-3488
  • Fax: 513-585-0011
Mailing address:
  • Phone: 513-585-3488
  • Fax: 513-585-0011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number18495
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number202205782NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: