Healthcare Provider Details

I. General information

NPI: 1093389389
Provider Name (Legal Business Name): ANDREA FLOWERS LMBT,MMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 HAY ST STE 221
FAYETTEVILLE NC
28301-5686
US

IV. Provider business mailing address

108 HAY ST STE 221
FAYETTEVILLE NC
28301-5686
US

V. Phone/Fax

Practice location:
  • Phone: 910-421-8623
  • Fax:
Mailing address:
  • Phone: 910-286-2603
  • Fax: 910-565-6014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number18916
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: