Provider Demographics
NPI:1881975910
Name:ACHENBACH, ANDREA ELIZABETH
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:ELIZABETH
Last Name:ACHENBACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 COLLEGE OF NURSING BLDG
Mailing Address - Street 2:COLLEGE OF NURSING-HOUSE CALLS
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1117
Mailing Address - Country:US
Mailing Address - Phone:319-248-1267
Mailing Address - Fax:888-674-8344
Practice Address - Street 1:101 COLLEGE OF NURSING BLDG
Practice Address - Street 2:COLLEGE OF NURSING-HOUSE CALLS
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1117
Practice Address - Country:US
Practice Address - Phone:319-248-1267
Practice Address - Fax:888-674-8344
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA120113163WG0000X
IAA120113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice