Healthcare Provider Details

I. General information

NPI: 1841128386
Provider Name (Legal Business Name): ANDREA LYNN JEWETT APRN-NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 E BROADWAY STE 431
EUGENE OR
97401-3158
US

IV. Provider business mailing address

3118 W SILVER CREEK DR
SAN TAN VALLEY AZ
85144-6095
US

V. Phone/Fax

Practice location:
  • Phone: 541-390-4559
  • Fax:
Mailing address:
  • Phone: 520-402-7881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10061507
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number246163
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: