Idal Roscin Tchoundjo, DNP ,FNP, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2010013258 Issued in MD

Practice address

2240 Winrow Rd
Fort Huachuca, AZ 85613-5080

Phone

(520) 533-9200

Fax

(520) 533-5246

NPI assigned

Jan 18, 2012

Last updated

Sep 22, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1932470283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 WINROW RD",
            "city": "FORT HUACHUCA",
            "state": "AZ",
            "postal_code": "856135080",
            "telephone_number": "520-533-9200",
            "fax_number": "520-533-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 WINROW RD",
            "city": "FORT HUACHUCA",
            "state": "AZ",
            "postal_code": "856135080",
            "telephone_number": "520-533-9200",
            "fax_number": "520-533-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TCHOUNDJO",
        "first_name": "IDAL",
        "middle_name": "ROSCIN",
        "name_prefix": "Dr.",
        "credential": "DNP ,FNP, CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "2010013258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rashamel Smart
• Robert J Staggs, FNP
• Daniel Paul Stokes, PA
• Blake Charles Stuart, D.D.S
• Christopher N. Sullins, LCSW
• Kelly Thomas, LPN
• Debra A Thornby
• Rachel Tripp
• David W Trull, OD
• Stephanie Tyson

• Family Nurse Practitioner in Fort Huachuca, AZ
• Providers in Fort Huachuca, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.