MEDICARE: SAFIYA DE LANDRO

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
1	163W00000X	Registered Nurse	247973	GA

General Provider Information

NPI Number	:	1518826502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAFIYA DE LANDRO

Provider Business Mailing Address
First Line	:	105 KENNINGHALL DR SE
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-3889
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 SAND CASTLE CT
Second Line	:
City	:	HAMPTON
State	:	GA
Zip	:	30228-6055
Country	:	US
Telephone Number	:	470-716-2021
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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Directions to “ SAFIYA DE LANDRO ” Practice Location

Language	Start Address	Practice Location

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