Individual
ANDREA RENEE HALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6129 W US HIGHWAY 60, BROOKLINE, MO 65619-9441
(662) 420-1086
(417) 708-5055
Mailing address
6129 W US HIGHWAY 60, BROOKLINE, MO 65619-9441
(662) 420-1086
(417) 708-5055
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2009021248
MO
183700000X
Pharmacy Technician
2019008294
MO
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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