Individual
ANDREA GILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
703 N 2ND AVE, IRON RIVER, MI 49935-1451
(906) 265-5126
Mailing address
703 N 2ND AVE, IRON RIVER, MI 49935-1451
(906) 265-5126
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00609563
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/29/2022
Last updated
07/29/2022
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