MEDICARE: ANDREA MARIE STONE

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	374J00000X	Doula

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	347J00000X	OTHER		DOULA

General Provider Information

NPI Number	:	1598490971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA MARIE STONE

Provider Business Mailing Address
First Line	:	12548 WISSANT LN
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-2723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12548 WISSANT LN
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-2723
Country	:	US
Telephone Number	:	636-288-0247
Fax Number	:

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

Provider Enumeration Date	:	07/20/2022
Last Update Date	:	07/20/2022

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Directions to “ ANDREA MARIE STONE ” Practice Location

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