MEDICARE: MS. VICKI L. ANDREWS CFNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	1285	WI
2	363LF0000X	Family Nurse Practitioner	284539-22	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	015R1AN	OTHER	MN	BCBS - MN
2	0113194	OTHER	MN	MEDICA
3	NA9591046223	OTHER	MN	PREFERRED ONE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063432086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICKI L. ANDREWS CFNP

Provider Business Mailing Address
First Line	:	1200 KENWOOD AVE
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55811-4199
Country	:	US
Telephone Number	:	218-723-6282
Fax Number	:	218-723-5953

Provider Business Practice Location Address
First Line	:	1200 KENWOOD AVE
Second Line	:
City	:	DULUTH
State	:	MN
Zip	:	55811-4199
Country	:	US
Telephone Number	:	218-723-6282
Fax Number	:	218-723-5953

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/01/2020

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