Provider Demographics
NPI:1538041470
Name:WESTBROOK, ANDREA MARIE
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 ELMHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-1409
Mailing Address - Country:US
Mailing Address - Phone:570-536-3277
Mailing Address - Fax:
Practice Address - Street 1:412 ELMHAVEN DR
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-1409
Practice Address - Country:US
Practice Address - Phone:570-536-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342637164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse