MEDICARE: JANICE KAY ANDREWS 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	163W00000X	Registered Nurse	RN0000039774	TN

General Provider Information

NPI Number	:	1649303314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE KAY ANDREWS R.N.

Provider Business Mailing Address
First Line	:	1372 CHISHOLM RD
Second Line	:
City	:	CYPRESS INN
State	:	TN
Zip	:	38452-4434
Country	:	US
Telephone Number	:	931-724-4690
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 JV MANGUBAT DR
Second Line	:
City	:	WAYNESBORO
State	:	TN
Zip	:	38485-2439
Country	:	US
Telephone Number	:	931-722-3292
Fax Number	:	931-722-7249

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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