MEDICARE: ANDREA CHRISTIE MAGEWICK APRN-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	11041307	FL

General Provider Information

NPI Number	:	1275417149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA CHRISTIE MAGEWICK APRN-C

Provider Business Mailing Address
First Line	:	936 SW 28TH TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-4295
Country	:	US
Telephone Number	:	586-668-1106
Fax Number	:

Provider Business Practice Location Address
First Line	:	13470 PARKER COMMONS BLVD STE 101
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-1850
Country	:	US
Telephone Number	:	239-379-8925
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2025
Last Update Date	:	01/12/2026

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