Basic Information
| Provider Information | |||||||||
| NPI: | 1447276670 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEPHENS | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 226 S WOODS MILL RD | ||||||||
| Address2: | STE 55W | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630173662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145424953 | ||||||||
| FaxNumber: | 3145905942 | ||||||||
| Practice Location | |||||||||
| Address1: | 226 S WOODS MILL RD | ||||||||
| Address2: | STE 55W | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630173662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3145424953 | ||||||||
| FaxNumber: | 3145905942 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2006 | ||||||||
| LastUpdateDate: | 02/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | R3P80 | MO | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 203102710 | 05 | MO | MEDICAID |