Healthcare Provider Details

I. General information

NPI: 1417294604
Provider Name (Legal Business Name): ANDREA F MCGREEVY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA TOLLIVER

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11570 E 126TH ST
FISHERS IN
46037-9592
US

IV. Provider business mailing address

10 S 9TH ST
NOBLESVILLE IN
46060-2630
US

V. Phone/Fax

Practice location:
  • Phone: 317-579-0166
  • Fax:
Mailing address:
  • Phone: 317-204-3736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number06004062A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: