Provider Demographics
NPI:1528448982
Name:BLUMER, ANDREA (APRN)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:BLUMER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:BRUNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:407 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66508-1503
Mailing Address - Country:US
Mailing Address - Phone:785-747-7248
Mailing Address - Fax:
Practice Address - Street 1:304 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:KS
Practice Address - Zip Code:66968-2033
Practice Address - Country:US
Practice Address - Phone:785-325-2211
Practice Address - Fax:785-325-3224
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76787363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care