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Individual
ANDREA M HUMPHREY
Active
Individual
ANDREA M HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-102973
IL
207Q00000X
Family Medicine Physician
Primary
67473
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102973
—
IL
Enumeration date
09/04/2007
Last updated
06/10/2024
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