MEDICARE: KATHLEEN ANDREWS OTR/L

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	314000000X	Skilled Nursing Facility	2014031296	MO

General Provider Information

NPI Number	:	1609263540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN ANDREWS OTR/L

Provider Business Mailing Address
First Line	:	2915 CHAPEL HILL RD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65203-3519
Country	:	US
Telephone Number	:	217-242-4882
Fax Number	:

Provider Business Practice Location Address
First Line	:	3003 FALLING LEAF CT
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65201-3549
Country	:	US
Telephone Number	:	573-355-9684
Fax Number	:

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

Provider Enumeration Date	:	04/17/2015
Last Update Date	:	08/07/2017

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