Healthcare Provider Details

I. General information

NPI: 1841843547
Provider Name (Legal Business Name): TREANNA IRIS ANASTASIA APN, WHNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 W DRAKE RD
FORT COLLINS CO
80526-5556
US

IV. Provider business mailing address

702 W DRAKE RD BUILDING E, SUITE B-102
FORT COLLINS CO
80526-5556
US

V. Phone/Fax

Practice location:
  • Phone: 970-231-2373
  • Fax: 800-886-9502
Mailing address:
  • Phone: 970-231-2373
  • Fax: 800-886-9502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPN.1000750-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRXN.0109708-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License NumberRN.1671958
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: