Childress, Andrea Lynn
Childress, Andrea Lynn is an sole proprietor health care provider with primary practice located at 3377 Riverbend Drive Peacehealth Hospital Medicine, Springfield OR 97477-8803. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Childress, Andrea Lynn can be contacted via phone (541) 222-6389.Contact Information
Primary practice address
3377 Riverbend Drive Peacehealth Hospital Medicine
Springfield OR 97477-8803
Phone: (541) 222-6389
Fax: (541) 222-6385
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AP60097977 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | AP60097977 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | AP60097977 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 201250121NP | Oregon |
Profile Details
| NPI number | 1710211768 |
|---|---|
| LBN Legal business name | Childress, Andrea Lynn |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 23rd, 2009 |
| Last updated | Jul 24th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710211768 | NPPES |
| Oregon | MEDICAID | 5006125438 |
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