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General NPI Number Information
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NPI Number | 1699234310
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Entity Type | Individual
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Provider Name | ANDREA LYNN SOMERS MSN, PMHNP-BC, PNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/13/2019
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 149 THOMPSON AVE E STE 150
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City | WEST ST PAUL
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State | MN
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Zip | 55118-3238
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Country | US
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Telephone | 651-450-0860
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Fax | 651-450-0759
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Provider Business Mailing Address
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Address Line | 4240 PARK GLEN RD
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-5427
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Country | US
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Telephone | 612-925-6033
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Fax | 612-925-8496
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 201912762
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 6509
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License Number State | MN
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