MR. ANDREW NADIR WICKWIRE (NPI# 1982115275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982115275 |
| Entity Type | Individual |
| Full Name | MR. ANDREW NADIR WICKWIRE |
| Credential | PA-C |
| Practice Address |
255 N Herwaldt Dr Fresno CA 93701-2186 |
| Mailing Address |
2625 E Divisadero St Fresno CA 93721-1431 |
| Practice Telephone | 8663426012 |
| Mailing Telephone | 5594432682 |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2020-01-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 55075 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
55075 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2823 Fresno St, Fresno, CA 937211324 | 5594593770 |
| Street Address |
255 N HERWALDT DR |
| City | FRESNO |
| State | CA |
| Zip Code | 93701-2186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780660761 | Simon Francis Dougherty | Physician Assistant | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2005-12-21 |
| 1609384940 | Family Healthcare Network | Clinic/Center | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2018-01-22 |
| 1578004164 | Steven Gunnell | Physician Assistant | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2017-03-15 |
| 1629529540 | Charles William-wesley Hurd | Physician Assistant | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2016-10-14 |
| 1891178182 | Annie Michele Fagundes | Nurse Practitioner | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2015-07-04 |
| 1871905984 | Veronica L Demary | Physician Assistant | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2014-05-22 |
| 1255751434 | Christopher J. Cortez | Physician Assistant | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2014-04-26 |
| 1326478041 | Mary Casner Hudson | Physician Assistant | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2013-11-15 |
| 1205265964 | Cameron Avon Adain Baker | Physician Assistant | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2013-11-04 |
| 1609111624 | Jocelyn Chia Lu | Physician Assistant | 255 N Herwaldt Dr, Fresno, CA 93701-2186 | 2012-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740244 | Tamara Sue Stanic | Registered Nurse | 215 N. Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-29 |
| 1144849829 | Katelyn Nicole Van Leir | Student in an Organized Health Care Education/Training Program | Surabian Dental Care Center - Suite 2500, 290 N. Wayte Lane, Fresno, CA 93701 | 2020-04-13 |
| 1003445693 | Michelle Edwardson | Registered Nurse | 215 North Fresno Street, Suite 370, Fresno, CA 93701 | 2020-04-06 |
| 1184253924 | Patricia Calderon | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-03 |
| 1922637032 | Leticia Lopez | Registered Nurse | 215 N. Fresno Street, Suite 230, Fresno, CA 93701 | 2020-04-02 |
| 1275026585 | Yesenia Gonzalez | Nurse Practitioner | 311 Abby Street, Fresno, CA 93701 | 2018-06-11 |
| 1710474606 | Amanda Juarez | Dietitian, Registered | 215 N Fresno, Suite 370, Fresno, CA 93701 | 2018-04-17 |
| 1235650391 | Plastic Surgery Partners of Fresno Inc | Plastic Surgery | 215 N Fresno St, Ste 490, Fresno, CA 93701 | 2017-06-29 |
| 1205369790 | Amy Alagh | Student in an Organized Health Care Education/Training Program | 155 N Fresno Street, Fresno, CA 93701 | 2017-04-11 |
| 1922462159 | Henry Matthew Dunn | Student in an Organized Health Care Education/Training Program | Ucsf Fresno, 155 N. Fresno St., Department of Orthopaedic Surgery, Fresno, CA 93701 | 2016-04-13 |
| Find all providers in zip 93701 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043720741 | Luis Rodriguez Gonzalez | Physician Assistant | 4730 Brazos Point Ln, Fresno, TX 77545-7968 | 2017-10-07 |
| 1407241300 | Gwendolyn Champion | Physician Assistant | 4026 E Teal Estates Cir, Fresno, TX 77545 | 2015-03-30 |
| 1740326891 | Michael J Sinopoli | Physician Assistant | 4910 E Clinton Way Ste 101, Fresno, CA 93727-1560 | 2007-01-29 |
| 1881212397 | Veshudha Kang | Physician Assistant | 2615 E Clinton Ave, Fresno, CA 93703-2223 | 2020-07-10 |
| 1154941011 | Kylie Wermund | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2020-04-21 |
| 1326604216 | Kelsey Tallman | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2019-05-15 |
| 1306402532 | Justin Frances Gagnon | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2019-05-13 |
| 1821532292 | Tran Luong | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2016-12-05 |
| 1487003414 | Maribel Manriquez | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2016-06-09 |
| 1558739052 | Kathryn L. Hanks | Physician Assistant | 2823 Fresno St, Fresno, CA 93721-1324 | 2015-09-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.