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NPI Code Detail

MEDICARE: AUDRA BIERMANN

MEDICARE: AUDRA BIERMANN
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
1103TC0700XClinical Psychologist2022050056MO

General Provider Information

NPI Number : 1881469864
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDRA BIERMANN
Provider Business Mailing Address
First Line : 600 E 5TH ST
Second Line :
City : FULTON
State : MO
Zip : 65251-1793
Country : US
Telephone Number : 573-592-2030
Fax Number :
Provider Business Practice Location Address
First Line : 600 E 5TH ST
Second Line :
City : FULTON
State : MO
Zip : 65251-1793
Country : US
Telephone Number : 573-592-2030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2023
Last Update Date : 11/20/2023

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Directions to “ AUDRA BIERMANN ” Practice Location

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