Provider Demographics
NPI:1033489448
Name:MATHIASON, ANDREA W (FNP-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:W
Last Name:MATHIASON
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19875 N 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5114
Mailing Address - Country:US
Mailing Address - Phone:623-581-8998
Mailing Address - Fax:623-581-6461
Practice Address - Street 1:28471 N VISTANCIA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-2092
Practice Address - Country:US
Practice Address - Phone:623-327-8800
Practice Address - Fax:623-327-8806
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAP4310363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily