Provider Demographics
NPI:1235477522
Name:ALLEN, ANDREA SANDERSON (WHNP-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:SANDERSON
Last Name:ALLEN
Suffix:
Gender:F
Credentials:WHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 DR MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-2807
Mailing Address - Country:US
Mailing Address - Phone:181-692-3580
Mailing Address - Fax:
Practice Address - Street 1:12200 W 106TH ST STE 125
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2305
Practice Address - Country:US
Practice Address - Phone:913-599-1396
Practice Address - Fax:913-599-1399
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012029015363LW0102X
KS53-79951-011363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health