Healthcare Provider Details

I. General information

NPI: 1437557261
Provider Name (Legal Business Name): ANDREA B FERREBEE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2014
Last Update Date: 04/07/2022
Certification Date: 03/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S BERETANIA ST SUITE 550
HONOLULU HI
96814-1870
US

IV. Provider business mailing address

HQ MEDDACB UNIT 28037 BLD 700
APO AE
09112
US

V. Phone/Fax

Practice location:
  • Phone: 808-381-8947
  • Fax: 808-591-2245
Mailing address:
  • Phone: 314-590-2368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-3911
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: