Provider Demographics
NPI:1871242743
Name:CARON, ANDREA LEIGH (FNP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LEIGH
Last Name:CARON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-1548
Mailing Address - Country:US
Mailing Address - Phone:231-526-2161
Mailing Address - Fax:231-526-5252
Practice Address - Street 1:750 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-1548
Practice Address - Country:US
Practice Address - Phone:231-526-2161
Practice Address - Fax:231-526-5252
Is Sole Proprietor?:No
Enumeration Date:2022-03-19
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704305866363LF0000X, 363LF0000X
MI4704305866NSA220BZ363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily