Healthcare Provider Details

I. General information

NPI: 1619119351
Provider Name (Legal Business Name): ANDREA LYNNE MUELLER RN, MN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2009
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2611 TIETON DR
YAKIMA WA
98902-3757
US

IV. Provider business mailing address

888 SWIFT BLVD
RICHLAND WA
99352-3514
US

V. Phone/Fax

Practice location:
  • Phone: 509-575-8026
  • Fax:
Mailing address:
  • Phone: 509-946-4611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN 00144552
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAP60098720
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: