Provider Demographics
NPI:1275417149
Name:MAGEWICK, ANDREA CHRISTIE (APRN-C)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CHRISTIE
Last Name:MAGEWICK
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:CHRISTIE
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:936 SW 28TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-4295
Mailing Address - Country:US
Mailing Address - Phone:586-668-1106
Mailing Address - Fax:
Practice Address - Street 1:15730 NEW HAMPSHIRE CT STE 101
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5539
Practice Address - Country:US
Practice Address - Phone:586-668-1106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11041307363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health