Healthcare Provider Details

I. General information

NPI: 1740664028
Provider Name (Legal Business Name): D'ANDRA MARIE LINDBUCHLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2015
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 GLENMAURA NATIONAL BLVD
MOOSIC PA
18507-2101
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-301-5000
  • Fax: 570-704-5073
Mailing address:
  • Phone: 570-301-5000
  • Fax: 570-704-5073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP026764
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP015157
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN587464
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: