Individual
MRS. DIENNA LOUISE LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2249 ELM ROAD EXT, CORTLAND, OH 44410
(330) 372-1608
(330) 372-1633
Mailing address
9394 ST RT 7, KINSMAN, OH 44428
(330) 876-0709
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP08479
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2631996
—
OH
Enumeration date
12/08/2006
Last updated
07/08/2007
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