Individual
DR. LATRAIA SHANAE LANDRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
(719) 310-0627
Mailing address
2501 CAPEHART RD, BELLEVUE, NE 68123-6418
(402) 294-9258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101265749
VA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
0101265749
VA
Other
Enumeration date
06/27/2017
Last updated
12/09/2022
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