Provider Demographics
NPI:1053144428
Name:DAVIS-STEELE, ANDREA (FNP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:DAVIS-STEELE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:DAVIS-STEELE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:192 WINDY DR
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06705-2516
Mailing Address - Country:US
Mailing Address - Phone:203-510-8664
Mailing Address - Fax:
Practice Address - Street 1:56 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1253
Practice Address - Country:US
Practice Address - Phone:203-709-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTAG08240061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily