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NPI Code Detail

MEDICARE: COLLIN E ANDRUS

MEDICARE: COLLIN E ANDRUS
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
1367500000XCertified Registered Nurse Anesthetist168419-30WI

General Provider Information

NPI Number : 1982253647
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLIN E ANDRUS
Provider Business Mailing Address
First Line : PO BOX 22487
Second Line :
City : GREEN BAY
State : WI
Zip : 54305-2487
Country : US
Telephone Number : 920-445-7210
Fax Number : 920-445-7289
Provider Business Practice Location Address
First Line : 744 S WEBSTER AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54301-3505
Country : US
Telephone Number : 920-433-3605
Fax Number : 920-433-3589
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2019
Last Update Date : 03/19/2026

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Directions to “ COLLIN E ANDRUS ” Practice Location

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