Provider Demographics
NPI:1053723676
Name:GAYDEN, ANDREA ROCHE (ANP-BC)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:ROCHE
Last Name:GAYDEN
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:ROCHE'
Other - Last Name:HAYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:8225 MALL PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:STONECREST
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6996
Mailing Address - Country:US
Mailing Address - Phone:770-981-2100
Mailing Address - Fax:
Practice Address - Street 1:8225 MALL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:STONECREST
Practice Address - State:GA
Practice Address - Zip Code:30038-6996
Practice Address - Country:US
Practice Address - Phone:770-981-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN208594363LA2200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health