Provider Demographics
NPI:1346544129
Name:ANDREWS, DESIRRE C S (CPM, RM, LCCE)
Entity Type:Individual
Prefix:
First Name:DESIRRE
Middle Name:C S
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:CPM, RM, LCCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6180 LEHMAN DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3444
Mailing Address - Country:US
Mailing Address - Phone:719-331-1292
Mailing Address - Fax:719-452-3550
Practice Address - Street 1:6180 LEHMAN DR
Practice Address - Street 2:SUITE 103
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3444
Practice Address - Country:US
Practice Address - Phone:719-331-1292
Practice Address - Fax:719-452-3550
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
CO145176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO145OtherNOT APPLICABLE