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Andrea E Ivy, NP
Family Nurse Practitioner in Bridgeton, Missouri
NPI 1649220104

Andrea E Ivy is a Family Nurse Practitioner based in Bridgeton, MO and is specialized in Family. Andrea E Ivy practices in Bridgeton, MO and has the professional credentials of NP. The NPI Number for Andrea E Ivy is 1649220104 and holds a License No. 137743 (Missouri).

The current practice location address for Andrea E Ivy is 12800 Boenker Ln, Bridgeton, MO and can be reached out via phone at 314-551-0338 and via fax at 314-551-0336.

Location: 12800 Boenker Ln, Bridgeton, MO, 63044-2438
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649220104
Provider Name
Andrea E Ivy
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
12800 Boenker Ln, Bridgeton, MO, 63044-2438
Phone Number
314-551-0338
Fax Number
314-551-0336
Provider Enumeration Date
05/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
429398209 05 MO
institution
Provider Business Practice Location Address Details
Address
12800 Boenker Ln
City
Bridgeton
State
Missouri
Zip
63044-2438
Phone Number
314-551-0338
Fax Number
314-551-0336
person
Provider Business Mailing Address Details
Address
12800 Boenker Ln
City
Bridgeton
State
Missouri
Zip
63044-2438
Phone Number
314-551-0338
Fax Number
314-551-0336
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
137743 (Missouri)
Definition
Definition to come...
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