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NPI Code Detail

MEDICARE: MR. ANDREW B. SIEFF A.P.N., B.C.

MEDICARE: MR. ANDREW B. SIEFF A.P.N., B.C.
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
1364SP0809XAdult Psychiatric/Mental Health Clinical Nurse SpecialistS01096AR

General Provider Information

NPI Number : 1568414191
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDREW B. SIEFF A.P.N., B.C.
Provider Business Mailing Address
First Line : 11183 BLACK OAK ADDITION
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72701-0787
Country : US
Telephone Number : 479-871-2005
Fax Number : 479-582-1085
Provider Business Practice Location Address
First Line : 111 E DAVIDSON ST
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72701-3413
Country : US
Telephone Number : 479-871-2005
Fax Number : 479-582-1085
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 07/08/2007

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