MEDICARE: MIE LIDY DEBORAH ELIZABETH ANDRE

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	163W00000X	Registered Nurse	N37795-01	NY

General Provider Information

NPI Number	:	1588596282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIE LIDY DEBORAH ELIZABETH ANDRE

Provider Business Mailing Address
First Line	:	8655 SHADOW RIDGE LN APT G
Second Line	:	APT G
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-8537
Country	:	US
Telephone Number	:	929-312-1148
Fax Number	:

Provider Business Practice Location Address
First Line	:	8655 SHADOW RIDGE LN APT G
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46239-8537
Country	:	US
Telephone Number	:	929-312-1148
Fax Number	:

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

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

Similar Medicare Providers

1275464877 — JOURNEE'S & COMPANY LLC
Practice Location Address:

7904 FOX GLEN DR
INDIANAPOLIS, IN
46239-8619

Practice Phone: 317-603-6655
Practice Fax:

1194656041 — MARIA TORRENCE REGISTERED NURSE
Practice Location Address:

1814 JESSICA DR
INDIANAPOLIS, IN
46239-9797

Practice Phone: 844-244-4930
Practice Fax: 971-316-1896

1144802703 — MEGAN MARIE STERNEN MS, OTR/L
Practice Location Address:

10335 CORYDON CT
INDIANAPOLIS, IN
46239-9781

Practice Phone: 317-406-9883
Practice Fax:

1225967839 — JUILLET KOFA FNP
Practice Location Address:

7850 BULLFINCH LN
INDIANAPOLIS, IN
46239-7955

Practice Phone: 267-499-0182
Practice Fax:

1023651072 — SHAWNTA CRAYTON NP
Practice Location Address:

10721 CRELL CT
INDIANAPOLIS, IN
46239-9770

Practice Phone: 317-680-5402
Practice Fax: 949-882-0475

1144158288 — THE RECOVERY VILLAGE INDIANA, LLC
Practice Location Address:

8150 BROOKVILLE RD
INDIANAPOLIS, IN
46239-8903

Practice Phone: 305-785-5520
Practice Fax: 888-919-4431

Directions to “ MIE LIDY DEBORAH ELIZABETH ANDRE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.