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NPI Code Detail

MEDICARE: ANDREA MARY NOBLE

MEDICARE: ANDREA MARY NOBLE
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
1106S00000XBehavior TechnicianMN

General Provider Information

NPI Number : 1952952509
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA MARY NOBLE
Provider Business Mailing Address
First Line : 402 2ND AVE SW APT 8
Second Line :
City : KASSON
State : MN
Zip : 55944-1296
Country : US
Telephone Number : 507-358-8253
Fax Number :
Provider Business Practice Location Address
First Line : 1470 INDUSTRIAL DR NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0700
Country : US
Telephone Number : 507-358-8253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2019
Last Update Date : 12/30/2019

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Directions to “ ANDREA MARY NOBLE ” Practice Location

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