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Individual

LAVON KAY LANDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
104C WILLIAMSPORT CIR, SALISBURY, MD 21804-6400
(410) 831-3899
Mailing address
727 W IVY DR, SEAFORD, DE 19973-1221
(302) 515-6935

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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