Provider Demographics
NPI:1790106391
Name:HERKENHOFF, ANDREA NICOLE (PNP)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:NICOLE
Last Name:HERKENHOFF
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Gender:F
Credentials:PNP
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Mailing Address - Street 1:1 CHILDRENS PL
Mailing Address - Street 2:NWT 1230
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-2694
Mailing Address - Fax:314-454-2694
Practice Address - Street 1:1 CHILDRENS PL STE C
Practice Address - Street 2:STE C
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-2694
Practice Address - Fax:314-454-2515
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2018-01-24
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Provider Licenses
StateLicense IDTaxonomies
MO2006022384363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics