Basic Information
| Provider Information | |||||||||
| NPI: | 1669081907 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDRADE | ||||||||
| FirstName: | GUADALUPE | ||||||||
| MiddleName: | YEDITH | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2544 COURT DR | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280543450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046716400 | ||||||||
| FaxNumber: | 7046716449 | ||||||||
| Practice Location | |||||||||
| Address1: | 2544 COURT DR STE A | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280543450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046716400 | ||||||||
| FaxNumber: | 7046716449 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2020 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 5014277 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
No ID Information.