Healthcare Provider Details

I. General information

NPI: 1649619503
Provider Name (Legal Business Name): ANDREW DYKE VARNEY FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 08/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BELLISIO HEALTH CENTER 81 E. BROADWAY ST.
JACKSON OH
45640-1186
US

IV. Provider business mailing address

60 CAPITAL DR
CHILLICOTHEE OH
45601-1186
US

V. Phone/Fax

Practice location:
  • Phone: 740-469-4770
  • Fax: 740-217-1161
Mailing address:
  • Phone: 740-779-4100
  • Fax: 740-779-4139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.14671
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: