Provider Demographics
NPI:1366190498
Name:MIKSITS, ANDREA COLENE (FNP-BC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:COLENE
Last Name:MIKSITS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 CYPRESS HILL DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-3702
Mailing Address - Country:US
Mailing Address - Phone:469-450-7897
Mailing Address - Fax:
Practice Address - Street 1:5180 EL DORADO PARKWAY
Practice Address - Street 2:STE 202
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:972-540-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1071078207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine