Provider Demographics
NPI:1174070536
Name:TZITZICAS, LEANDREA J (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LEANDREA
Middle Name:J
Last Name:TZITZICAS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LEANDREA
Other - Middle Name:
Other - Last Name:STOUFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3920 N UNION BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-1907
Mailing Address - Country:US
Mailing Address - Phone:719-694-3595
Mailing Address - Fax:719-493-9936
Practice Address - Street 1:3920 N UNION BLVD STE 150
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-1907
Practice Address - Country:US
Practice Address - Phone:719-694-3595
Practice Address - Fax:719-493-9936
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1642577363LF0000X
WVWV107150363LF0000X
COC-APN.0002328-C-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily