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Individual
MRS. PHYLLIS NADEAU LANDERS
Active
Individual
MRS. PHYLLIS NADEAU LANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN096607
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01372617
AMERIGROUP
GA
01
—
563030
WELLCARE OF GEORGIA
GA
05
—
701221561A
—
GA
Enumeration date
11/20/2007
Last updated
07/19/2011
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