Provider Demographics
NPI:1609330596
Name:HOERR, ANDREA JANE (APN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JANE
Last Name:HOERR
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6610 W CHALLACOMBE RD
Mailing Address - Street 2:
Mailing Address - City:EDWARDS
Mailing Address - State:IL
Mailing Address - Zip Code:61528-9739
Mailing Address - Country:US
Mailing Address - Phone:309-696-8543
Mailing Address - Fax:
Practice Address - Street 1:111 E KNOXVILLE ST
Practice Address - Street 2:
Practice Address - City:BRIMFIELD
Practice Address - State:IL
Practice Address - Zip Code:61517-8022
Practice Address - Country:US
Practice Address - Phone:309-446-3305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.018711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily