Individual
ANDREA EARLYWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
2100 FORUM BLVD STE C-2, COLUMBIA, MO 65203-5436
(573) 447-7456
(573) 447-7457
Mailing address
1324 WEAVER DR, COLUMBIA, MO 65203-0888
(573) 228-0466
(573) 447-7457
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2001024627
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679778617
—
MO
Enumeration date
06/19/2007
Last updated
08/04/2021
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