Provider Demographics
NPI:1932675840
Name:SWEARINGEN, ANDREA N (LMT)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:N
Last Name:SWEARINGEN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SKY VUE DR STE B
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-8203
Mailing Address - Country:US
Mailing Address - Phone:816-548-7890
Mailing Address - Fax:
Practice Address - Street 1:100 SKY VUE DR STE B
Practice Address - Street 2:
Practice Address - City:RAYMORE
Practice Address - State:MO
Practice Address - Zip Code:64083-8203
Practice Address - Country:US
Practice Address - Phone:816-548-7890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006026746225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist