Healthcare Provider Details

I. General information

NPI: 1699170696
Provider Name (Legal Business Name): NADIA CAMPOS DE ANDRADE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2014
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S GEORGE ST FL 2
YORK PA
17403-3676
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-2465
  • Fax: 717-741-3043
Mailing address:
  • Phone: 717-851-2465
  • Fax: 717-741-3043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN727851
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5007286
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberMC4823806
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP021830
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: