Individual
ANDREA ELENA PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 269-7566
Mailing address
535 W WALNUT ST APT 205, SPRINGFIELD, MO 65806-2191
(314) 799-4713
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
2017031674
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2017031674
MISSOURI PHARMACIST LICENSE
MO
Enumeration date
07/31/2019
Last updated
07/31/2019
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