Andrea Lynn Davenport, MS, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Cayuga, IN
NPI 1487206306 · NPPES record last updated Jul 11, 2019
Key facts
- NPI
- 1487206306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71009111A (IN)
- Practice address
- 703 W Park St
Cayuga, IN 47928-8207 - Phone
- (765) 492-9042
- NPI assigned
- Jul 11, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190912001007 | IN | Practitioner - Nurse Practitioner | 5991034217 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71009111A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Professionals Community Health Center Inc | Current |
Accepting new patients | |
| Valley Professionals Community Health Center, Inc. | Current |
Accepting new patients |
Locations
703 W Park St
Cayuga, IN 47928
Phone (765) 492-9042
777 S Main St
Ste 100
Clinton, IN 47842
Phone (765) 828-1003
1702 Lafayette Rd
Crawfordsvlle, IN 47933
Phone (765) 362-4400
727 N Lincoln Rd
Rockville, IN 47872
Phone (765) 569-1123
4757 S 7th St
Terre Haute, IN 47802
Phone (812) 234-2289
1530 N 7th St
Ste 201
Terre Haute, IN 47807
Phone (812) 238-7631
601 W National Ave
West Terre Haute, IN 47885
Phone (812) 244-1515
Interoperability endpoints
- andrea.davenport.1@23284.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71009111A | IN | Yes |
Addresses
Primary practice location
703 W Park St
Cayuga, IN 47928-8207
Mailing address
4264 S 430 E
Kingman, IN 47952-8037
Phone (765) 376-2320
Other names
- Miss Andrea Lynn Wilson
Other providers in Cayuga, IN
- Jeffrey Kent Binder
- Zakary Bushue
- Megan Castaneda
- Harrell'S Home Healthcare, LLC
- North Vermillion Comm. School Corporation
- Parke Clinic, PC
- Janet Ann Rutter
- Erik P Southard
All providers in Cayuga, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.