Healthcare Provider Details

I. General information

NPI: 1679335392
Provider Name (Legal Business Name): TANYA VAN VOORST AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 W CHERRY ST STE A
NORTH LIBERTY IA
52317-9797
US

IV. Provider business mailing address

585 W CHERRY ST STE A
NORTH LIBERTY IA
52317-9849
US

V. Phone/Fax

Practice location:
  • Phone: 319-249-6925
  • Fax: 319-205-0625
Mailing address:
  • Phone: 319-249-6925
  • Fax: 319-205-0625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number00557
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number00557
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: