Provider Demographics
NPI:1871957126
Name:LOUIS JEAN, ANDY (ARNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:ANDY
Middle Name:
Last Name:LOUIS JEAN
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:LOUIS JEAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:215 ALEWIFE BROOK PKWY
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1101
Mailing Address - Country:US
Mailing Address - Phone:617-661-6422
Mailing Address - Fax:
Practice Address - Street 1:215 ALEWIFE BROOK PKWY
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1101
Practice Address - Country:US
Practice Address - Phone:617-661-6422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2316574363LF0000X
FL9385203363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily