MEDICARE: ANDREA LYNN SPIRA O'CONNOR N.M.D., R.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	09-1168	AZ

General Provider Information

NPI Number	:	1245569813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA LYNN SPIRA O'CONNOR N.M.D., R.N.

Provider Business Mailing Address
First Line	:	6102 N 16TH ST
Second Line	:	SUITE 17
City	:	PHOENIX
State	:	AZ
Zip	:	85016-1752
Country	:	US
Telephone Number	:	480-252-3799
Fax Number	:

Provider Business Practice Location Address
First Line	:	6102 N 16TH ST
Second Line	:	SUITE 17
City	:	PHOENIX
State	:	AZ
Zip	:	85016-1752
Country	:	US
Telephone Number	:	480-252-3799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2009
Last Update Date	:	12/10/2009

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