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NPI Code Detail

MEDICARE: MRS. TWYLA ANN LANDESS C.R.N.A.

MEDICARE: MRS. TWYLA ANN LANDESS C.R.N.A.
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
1367500000XCertified Registered Nurse Anesthetist4704156537MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14308754070OTHERMIBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457397333
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TWYLA ANN LANDESS C.R.N.A.
Provider Business Mailing Address
First Line : 321 E HARRIS ST
Second Line :
City : CHARLOTTE
State : MI
Zip : 48813-1629
Country : US
Telephone Number : 517-543-1050
Fax Number : 517-543-0875
Provider Business Practice Location Address
First Line : 321 E HARRIS ST
Second Line :
City : CHARLOTTE
State : MI
Zip : 48813-1629
Country : US
Telephone Number : 517-543-1050
Fax Number : 517-543-0875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 02/10/2012

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