MEDICARE: MS. SUSAN M. ANDREWS APRNBC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN0000005936	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00175298	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902897630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN M. ANDREWS APRNBC

Provider Business Mailing Address
First Line	:	910 MADISON AVE STE 922
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-0001
Country	:	US
Telephone Number	:	901-448-5630
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 MADISON AVE STE 922
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-0001
Country	:	US
Telephone Number	:	901-448-5630
Fax Number	:

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

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	12/04/2015

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