Healthcare Provider Details

I. General information

NPI: 1891280822
Provider Name (Legal Business Name): JOANNA KLUENDER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2018
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 EDWARDS ACCESS RD
EDWARDS CO
81632-5634
US

IV. Provider business mailing address

PO BOX 2598
EDWARDS CO
81632-2598
US

V. Phone/Fax

Practice location:
  • Phone: 970-445-2489
  • Fax: 704-706-5109
Mailing address:
  • Phone: 970-236-6696
  • Fax: 970-632-6200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0993937-NP
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0993937-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: