Clegg, Andrea

Clegg, Andrea is an individual health care provider with primary practice located at 22060 Beech St Ste 200 , Dearborn MI 48124-2853. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Clegg, Andrea can be contacted via phone (313) 228-0505.

Contact Information

Primary practice address
22060 Beech St Ste 200 Dearborn MI 48124-2853
Phone: (313) 228-0505
Fax: (313) 228-0506
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704218011 Michigan

Profile Details

NPI number 1285612861
LBN Legal business name Clegg, Andrea
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Jan 5th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285612861 NPPES
Other P00380696 RAILROAD MEDICARE
MEDICAID 10-4773390 RAILROAD MEDICARE
MEDICAID 11-4941056 RAILROAD MEDICARE
MEDICAID 10-4773362 RAILROAD MEDICARE
MEDICAID 10-4773371 RAILROAD MEDICARE
MEDICAID 11-4941047 RAILROAD MEDICARE
Other 5008604240 RAILROAD MEDICARE
MEDICAID 11-4941038 RAILROAD MEDICARE
MEDICAID 11-4941065 RAILROAD MEDICARE
MEDICAID 10-4773406 RAILROAD MEDICARE
Other 11712499 RAILROAD MEDICARE
MEDICAID 10-4773380 RAILROAD MEDICARE

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