Active NPI
Andrea Lynn Logue
- Critical Care Medicine Registered Nurse
- Girard, OH
National Provider Identifier
1760052856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 336530
- Practice address
- 1007 N Ward Ave
Girard, OH 44420-1957 - Phone
- (330) 240-9497
- NPI assigned
- Jun 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 336530 | OH | Primary |
Addresses
Primary practice location
1007 N Ward Ave
Girard, OH 44420-1957
Mailing address
1007 N Ward Ave
Girard, OH 44420-1957
Phone (330) 240-9497
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 336530 | Other | OH | REGISTERED NURSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 336530 | OH | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1760052856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 N WARD AVE",
"city": "GIRARD",
"state": "OH",
"postal_code": "444201957",
"telephone_number": "330-240-9497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 N WARD AVE",
"city": "GIRARD",
"state": "OH",
"postal_code": "444201957",
"telephone_number": "330-240-9497"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGUE",
"first_name": "ANDREA",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-30",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "OH",
"license": "336530",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGISTERED NURSE",
"identifier": "336530",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Girard, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.