MEDICARE: MRS. PATRICIA SUE LANDON F.N.P.

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	178610	OH
2	363LF0000X	Family Nurse Practitioner	18254	OH

General Provider Information

NPI Number	:	1467742825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA SUE LANDON F.N.P.

Provider Business Mailing Address
First Line	:	1064 STATE ROUTE 28 STE F
Second Line	:
City	:	MILFORD
State	:	OH
Zip	:	45150-4940
Country	:	US
Telephone Number	:	513-981-4050
Fax Number	:

Provider Business Practice Location Address
First Line	:	1064 STATE ROUTE 28 STE F
Second Line	:
City	:	MILFORD
State	:	OH
Zip	:	45150-4940
Country	:	US
Telephone Number	:	513-981-4050
Fax Number	:

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

Provider Enumeration Date	:	04/19/2011
Last Update Date	:	03/05/2024

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