Provider Demographics
NPI:1629341250
Name:ANDRYCHOWICZ, NOELLE J (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:J
Last Name:ANDRYCHOWICZ
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 FOUNDERS PARK DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762
Mailing Address - Country:US
Mailing Address - Phone:479-463-6680
Mailing Address - Fax:479-463-6624
Practice Address - Street 1:813 FOUNDERS PARK DR
Practice Address - Street 2:SUITE 107
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-463-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR214093163W00000X, 363L00000X
MNR173860-1163W00000X
MN217363L00000X
MN1738601363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant