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1649220104
ANDREA E IVY
BRIDGETON, MO
NPI
1649220104
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 137743)
Enumeration Date
2006-05-12
Last Update Date
2014-07-14
Business Address
-- ANDREA E IVY N.P.
12800 BOENKER LN
BRIDGETON, MO 63044-2438
Phone number: 314-551-0338
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Mailing Address
-- ANDREA E IVY N.P.
12800 BOENKER LN
BRIDGETON, MO 63044-2438
Phone number: 314-551-0338
Copy
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