Provider Demographics
NPI:1699886952
Name:STONECIPHER, ANDREA KAY (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:KAY
Last Name:STONECIPHER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:7000 PIPER GLEN DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-6756
Mailing Address - Country:US
Mailing Address - Phone:217-483-5800
Mailing Address - Fax:217-697-8431
Practice Address - Street 1:7000 PIPER GLEN DR
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-6756
Practice Address - Country:US
Practice Address - Phone:217-483-5800
Practice Address - Fax:217-697-8431
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-01-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL361151822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214354Medicare PIN