ANDREA E IVY N.P. NPI 1649220104

NPI Information

NPI: 1649220104
Provider Name: ANDREA E IVY, N.P.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Address:
12800 BOENKER LN
BRIDGETON, MO
ZIP 63044
Phone: (314) 551-0338
Get Directions

Andrea E Ivy, N.P. is a family nurse practitioner in Bridgeton, MO. Andrea E Ivy, N.P. NPI is 1649220104. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12800 BOENKER LN
BRIDGETON, MO
ZIP 63044-438
Phone: (314) 551-0338
Fax: (314) 551-0336

The enumeration date for this NPI number is 5/12/2006 and was last updated on 7/14/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	137743	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	Q27494	MEDICARE UPIN	MISSOURI
2	429398209	MEDICAID	MISSOURI
3	000013853	MEDICARE PIN	MISSOURI
4	822223853	MEDICARE PIN	MISSOURI
5	S39000003	MEDICARE PIN	MISSOURI
6	MA1084002	MEDICARE PIN	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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