Provider Demographics
NPI:1942745377
Name:STORJOHANN, ANDREA J (ARNP, CADC)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:J
Last Name:STORJOHANN
Suffix:
Gender:F
Credentials:ARNP, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1200 UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-2355
Mailing Address - Country:US
Mailing Address - Phone:515-248-1447
Mailing Address - Fax:515-248-1440
Practice Address - Street 1:412 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-2947
Practice Address - Country:US
Practice Address - Phone:641-753-4021
Practice Address - Fax:641-844-6222
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAT16170101YA0400X
IAG158390363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)