Provider Demographics
NPI:1144020199
Name:POINDEXTER, ANDRILL MICHELLE
Entity type:Individual
Prefix:MRS
First Name:ANDRILL
Middle Name:MICHELLE
Last Name:POINDEXTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ANDRILL
Other - Middle Name:MICHELLE
Other - Last Name:WATTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7905 L ST
Mailing Address - Street 2:STE 420
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127
Mailing Address - Country:US
Mailing Address - Phone:402-575-2654
Mailing Address - Fax:531-242-4420
Practice Address - Street 1:7905 L ST
Practice Address - Street 2:STE 420
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127
Practice Address - Country:US
Practice Address - Phone:402-575-2654
Practice Address - Fax:531-242-4420
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant