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NPI Code Detail

MEDICARE: BONNIE LANDGRAF

MEDICARE:   BONNIE  LANDGRAF
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 PractitionerTMP-153360KS

General Provider Information

NPI Number : 1255784518
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE LANDGRAF
Provider Business Mailing Address
First Line : PO BOX 746874
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6874
Country : US
Telephone Number : 312-733-9730
Fax Number : 312-929-0373
Provider Business Practice Location Address
First Line : 700 NEBRASKA AVE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66101-2111
Country : US
Telephone Number : 913-951-8731
Fax Number : 913-426-9057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2016
Last Update Date : 03/04/2024

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Directions to “ BONNIE LANDGRAF ” Practice Location

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