Healthcare Provider Details

I. General information

NPI: 1164191961
Provider Name (Legal Business Name): ANDREA JOYCE TSCHANNERL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BUCK CREEK RD STE 100
AVON CO
81620-5428
US

IV. Provider business mailing address

PO BOX 842578
KANSAS CITY MO
64184-2578
US

V. Phone/Fax

Practice location:
  • Phone: 970-926-6340
  • Fax:
Mailing address:
  • Phone: 970-926-6350
  • Fax: 970-926-6348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11012153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: