Individual
ANDREA FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
24 S MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63703-4914
(573) 331-5544
(573) 331-5545
Mailing address
PO BOX 843225, KANSAS CITY, MO 64184-3225
(708) 633-1234
(708) 342-7100
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
112131
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00385458
RAILROAD MEDICARE
—
Enumeration date
03/09/2007
Last updated
10/14/2012
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