Provider Demographics
NPI:1669747473
Name:DAY, ANDREA LYNN (ARNP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:DAY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 171
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-0171
Mailing Address - Country:US
Mailing Address - Phone:253-229-5504
Mailing Address - Fax:
Practice Address - Street 1:211 E MAIN AVE
Practice Address - Street 2:
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109
Practice Address - Country:US
Practice Address - Phone:253-229-5504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60235346163W00000X, 163WH0200X
ID62493363LF0000X
WAAP61038143363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health