Victoria Honorine Andersen I, BUSINESS OWNER (CNA)

Primary specialty

Nurse's AideTaxonomy code 376K00000X

License

114550A Issued in MO

Practice address

24386 State Highway Ra
Golden, MO 65658-8423

Phone

(417) 846-8485

NPI assigned

Mar 21, 2022

Last updated

Mar 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Victoria Honorine Andersen I Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1689323412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24386 STATE HIGHWAY RA",
            "city": "GOLDEN",
            "state": "MO",
            "postal_code": "656588423",
            "telephone_number": "417-846-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24386 STATE HIGHWAY RA",
            "city": "GOLDEN",
            "state": "MO",
            "postal_code": "656588423",
            "telephone_number": "417-846-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "VICTORIA",
        "middle_name": "HONORINE",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "BUSINESS OWNER (CNA)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MO",
            "license": "114550A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "ANDERSEN",
            "middle_name": "HONORINE",
            "suffix": "I",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Adrian R O'Brien, CPM, LM

• Nurse's Aide in Golden, MO
• Providers in Golden, MO by specialty
• Nurse's Aide in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.