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Individual
LAVON KAY LANDIS
Active
Individual
LAVON KAY LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L1-0068895
DE
163W00000X
Registered Nurse
R204090
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AC004066
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
L8-0010276
DE
Other
Enumeration date
06/29/2021
Last updated
12/22/2021
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