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Individual
JEANIE LANDES
Active
Individual
JEANIE LANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
120582
LA
207R00000X
Internal Medicine Physician
Primary
74826
NM
363L00000X
Nurse Practitioner
74826
NM
363LF0000X
Family Nurse Practitioner
200449
LA
Other
Enumeration date
05/02/2016
Last updated
10/20/2023
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