Healthcare Provider Details

I. General information

NPI: 1437722493
Provider Name (Legal Business Name): MICAH KAHAKAIOIKAMALIE ANDRADE ACNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2021
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ DIV NEUROLOGY, CRITICAL CARE MEDICINE
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-1408
  • Fax: 314-362-6033
Mailing address:
  • Phone: 314-362-1408
  • Fax: 314-362-6033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-3243
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number2024016473
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: