Provider Demographics
NPI:1700013828
Name:ANDREWS, KRISTINE EVA (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:EVA
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 MEDICAL GROUP
Mailing Address - Street 2:310 W. LOSEY STREET
Mailing Address - City:SCOTT AFB
Mailing Address - State:IL
Mailing Address - Zip Code:62225
Mailing Address - Country:US
Mailing Address - Phone:618-256-7018
Mailing Address - Fax:618-256-7594
Practice Address - Street 1:375 MEDICAL GROUP
Practice Address - Street 2:310 W. LOSEY STREET
Practice Address - City:SCOTT AFB
Practice Address - State:IL
Practice Address - Zip Code:62225
Practice Address - Country:US
Practice Address - Phone:618-256-7018
Practice Address - Fax:618-256-7594
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101248113208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics