Healthcare Provider Details

I. General information

NPI: 1730281031
Provider Name (Legal Business Name): DAPHNE K LANDERS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 CENTRAL AVENUE EAST
HAMPTON IA
50441
US

IV. Provider business mailing address

1720 CENTRAL AVENUE EAST
HAMPTON IA
50441
US

V. Phone/Fax

Practice location:
  • Phone: 641-456-5050
  • Fax: 641-456-5060
Mailing address:
  • Phone: 641-456-5050
  • Fax: 641-456-5060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA-093047
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: