Provider Demographics
NPI:1831394303
Name:ZYVERT, ANDREA LYNN
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LYNN
Last Name:ZYVERT
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 1:2237 SILVERTHORN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-1627
Mailing Address - Country:US
Mailing Address - Phone:815-226-1633
Mailing Address - Fax:815-227-1568
Practice Address - Street 1:2237 SILVERTHORN DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-1627
Practice Address - Country:US
Practice Address - Phone:815-226-1633
Practice Address - Fax:815-227-1568
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter