Healthcare Provider Details

I. General information

NPI: 1073499828
Provider Name (Legal Business Name): MERCEDES LANDRUS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 N RIVERSIDE RD STE 204
SAINT JOSEPH MO
64507-2518
US

IV. Provider business mailing address

PO BOX 56
WATHENA KS
66090-0056
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-6460
  • Fax: 816-271-6139
Mailing address:
  • Phone: 816-344-7895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025022080
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: