Provider Demographics
NPI:1427238120
Name:CHANDY, FLOSSY ACHENKUNJU (FNP)
Entity type:Individual
Prefix:MRS
First Name:FLOSSY
Middle Name:ACHENKUNJU
Last Name:CHANDY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:FLOSSY
Other - Middle Name:
Other - Last Name:ACHENKUNJU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1820 SAINT JOHNS AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2671
Mailing Address - Country:US
Mailing Address - Phone:972-529-2069
Mailing Address - Fax:
Practice Address - Street 1:920 2ND AVE S
Practice Address - Street 2:400
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-3318
Practice Address - Country:US
Practice Address - Phone:972-529-2069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX691556363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily