Healthcare Provider Details

I. General information

NPI: 1922238260
Provider Name (Legal Business Name): FRANCES MARIE LANDRUM FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 CARNEGIE PL STE 103
FAYETTEVILLE GA
30214-5900
US

IV. Provider business mailing address

409 W SOLOMON ST
GRIFFIN GA
30223-2831
US

V. Phone/Fax

Practice location:
  • Phone: 770-716-7999
  • Fax: 770-716-8444
Mailing address:
  • Phone: 678-688-8700
  • Fax: 678-688-8718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN164310
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: