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NPI Code Detail

MEDICARE: HEATHER LANDIS ANP

MEDICARE:   HEATHER  LANDIS  ANP
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
1363LP2300XPrimary Care Nurse Practitioner5012768NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15012768OTHERNCNURSE PRACTITIONER

General Provider Information

NPI Number : 1780216135
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER LANDIS ANP
Provider Business Mailing Address
First Line : 614 HOWARD ST
Second Line :
City : BOONE
State : NC
Zip : 28608-0020
Country : US
Telephone Number : 828-262-3100
Fax Number : 828-262-6958
Provider Business Practice Location Address
First Line : 614 HOWARD ST
Second Line :
City : BOONE
State : NC
Zip : 28608-0020
Country : US
Telephone Number : 828-262-3100
Fax Number : 828-262-6958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2020
Last Update Date : 02/05/2020

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Directions to “ HEATHER LANDIS ANP” Practice Location

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