Basic Information
| Provider Information | |||||||||
| NPI: | 1841720968 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PICKUP-SIMONIN | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | MSN, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 387 QUARRY STREET, SUITE 100 | ||||||||
| Address2: | |||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086798111 | ||||||||
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| Practice Location | |||||||||
| Address1: | 387 QUARRY ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027231026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086798111 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2017 | ||||||||
| LastUpdateDate: | 08/23/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN260456 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | RN260456 | MA | N | Nursing Service Providers | Registered Nurse |
No ID Information.