Provider Demographics
NPI:1770191611
Name:MCCARTNEY, ANDREA DAWN (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:DAWN
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR # CC101GH
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-621-9594
Mailing Address - Fax:
Practice Address - Street 1:3056 RIVER CROSSING CT STE A
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:IA
Practice Address - Zip Code:52327-4733
Practice Address - Country:US
Practice Address - Phone:319-467-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist