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NPI Code Detail

MEDICARE: LINDSAY MARIE LANDIS NP

MEDICARE: LINDSAY MARIE LANDIS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner810470TX
2363LF0000XFamily Nurse PractitionerCOA.16858-NPOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134553563
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSAY MARIE LANDIS NP
Provider Business Mailing Address
First Line : 564 EAST SECOND STREET
Second Line :
City : SALEM
State : OH
Zip : 44460-2914
Country : US
Telephone Number : 330-482-9350
Fax Number : 330-332-7915
Provider Business Practice Location Address
First Line : 564 EAST SECOND STREET
Second Line :
City : SALEM
State : OH
Zip : 44460-2914
Country : US
Telephone Number : 330-482-9350
Fax Number : 330-332-7915
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2013
Last Update Date : 08/26/2022

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