| Doctor Name: | ANDREA FAULKNER |
| NPI Number: | 1043341928 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 112131 |
| Business Practice Address: | 24 S Mount Auburn Rd Cape Girardeau, MO - 637034914 |
| Business Phone Number: | 5733315544 |
| Business Fax Number: | 5733315545 |
| Mailing Address: | Po Box 843225, KANSAS CITY |
| State: | MO |
| Postal Code: | 641843225 |
| Phone Number: | 7086331234 |
| Fax Number: | 7083427100 |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 10/14/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 112131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |