Provider Demographics
NPI:1851475529
Name:EGGERS, ANDRA
Entity Type:Individual
Prefix:
First Name:ANDRA
Middle Name:
Last Name:EGGERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 19TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-2752
Mailing Address - Country:US
Mailing Address - Phone:563-243-5633
Mailing Address - Fax:563-243-9567
Practice Address - Street 1:1320 19TH AVE NW
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-2752
Practice Address - Country:US
Practice Address - Phone:563-243-5633
Practice Address - Fax:563-243-9567
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08922Y163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse