Provider Demographics
NPI:1548862998
Name:ANDREWS, TANIQUA DENISE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:TANIQUA
Middle Name:DENISE
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3740 CURTIS BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOHN
Mailing Address - State:FL
Mailing Address - Zip Code:32927-3962
Mailing Address - Country:US
Mailing Address - Phone:321-633-5500
Mailing Address - Fax:321-633-5566
Practice Address - Street 1:3740 CURTIS BLVD STE 108
Practice Address - Street 2:
Practice Address - City:PORT ST JOHN
Practice Address - State:FL
Practice Address - Zip Code:32927-3962
Practice Address - Country:US
Practice Address - Phone:321-633-5500
Practice Address - Fax:321-633-5566
Is Sole Proprietor?:No
Enumeration Date:2020-11-11
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010293363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN4200OtherMEDICARE HF