Provider Demographics
NPI:1871984955
Name:POMA, ANDREA (CNP)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:POMA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:MOSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:350 NORTH MAIN STREET
Practice Address - Street 2:SUITE 150
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118
Practice Address - Country:US
Practice Address - Phone:734-593-5251
Practice Address - Fax:734-593-5255
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704227726363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health