Provider Demographics
NPI:1285523167
Name:MUSSELMAN, ANDREA JEAN
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEAN
Last Name:MUSSELMAN
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 1:165 OAK HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW ENTERPRISE
Mailing Address - State:PA
Mailing Address - Zip Code:16664-8630
Mailing Address - Country:US
Mailing Address - Phone:814-494-9413
Mailing Address - Fax:
Practice Address - Street 1:165 OAK HILL RD
Practice Address - Street 2:
Practice Address - City:NEW ENTERPRISE
Practice Address - State:PA
Practice Address - Zip Code:16664-8630
Practice Address - Country:US
Practice Address - Phone:814-494-9413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer