Healthcare Provider Details

I. General information

NPI: 1821398678
Provider Name (Legal Business Name): ANDREW N GARNER APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2010
Last Update Date: 10/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1723 BROADWAY ST
CAPE GIRARDEAU MO
63701-4566
US

IV. Provider business mailing address

1723 BROADWAY ST
CAPE GIRARDEAU MO
63701-4566
US

V. Phone/Fax

Practice location:
  • Phone: 573-331-7910
  • Fax: 573-331-7919
Mailing address:
  • Phone: 573-331-7910
  • Fax: 573-331-7919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number2010034380
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: