1841659927 NPI number — MS. ANDREA ELISE MCLARTY NP (RN MSN NP)

Table of content: MS. ANDREA ELISE MCLARTY NP (RN MSN NP) (NPI 1841659927)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841659927 NPI number — MS. ANDREA ELISE MCLARTY NP (RN MSN NP)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCLARTY
Provider First Name:
ANDREA
Provider Middle Name:
ELISE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
NP (RN MSN NP)
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHETTLER
Provider Other First Name:
ANDREA
Provider Other Middle Name:
ELISE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
NP (RN MSN NP)
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841659927
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2305 DE LA VINA STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA BARBARA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-682-5852
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2305 DE LA VINA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93105-3873
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-682-5852
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/17/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  17260 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)