Provider Demographics
NPI:1255122123
Name:MUIR, ANDREA CHRISTINE (RN, BSN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CHRISTINE
Last Name:MUIR
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 MORGAN DR
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-3805
Mailing Address - Country:US
Mailing Address - Phone:915-929-4486
Mailing Address - Fax:
Practice Address - Street 1:1631 MORGAN DR
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:MO
Practice Address - Zip Code:63052-3805
Practice Address - Country:US
Practice Address - Phone:915-929-4486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008029144163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse