Provider Demographics
NPI:1053153676
Name:NIERENBERG, ANDREW THOMAS (RN)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:THOMAS
Last Name:NIERENBERG
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 HUGHMONT DR
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2263
Mailing Address - Country:US
Mailing Address - Phone:512-947-4400
Mailing Address - Fax:
Practice Address - Street 1:1212 HUGHMONT DR
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2263
Practice Address - Country:US
Practice Address - Phone:512-947-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX802509163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse