Provider Demographics
NPI:1447882212
Name:ANDING, ADRIANNE PARKER
Entity type:Individual
Prefix:
First Name:ADRIANNE
Middle Name:PARKER
Last Name:ANDING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 N MONROE ST APT A
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:WI
Mailing Address - Zip Code:53594-1154
Mailing Address - Country:US
Mailing Address - Phone:608-301-6490
Mailing Address - Fax:
Practice Address - Street 1:324 N MONROE ST APT A
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:WI
Practice Address - Zip Code:53594-1154
Practice Address - Country:US
Practice Address - Phone:608-301-6490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
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