Healthcare Provider Details

I. General information

NPI: 1528448982
Provider Name (Legal Business Name): ANDREA BLUMER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA BRUNA APRN

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 MAY ST
MARYSVILLE KS
66508-1200
US

IV. Provider business mailing address

407 N 11TH ST
MARYSVILLE KS
66508-1503
US

V. Phone/Fax

Practice location:
  • Phone: 785-562-3942
  • Fax: 785-562-5149
Mailing address:
  • Phone: 785-747-7248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number76787
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: