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Individual

CHRISTINA MARIE LANDECK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
631 ALLENWOOD LOOP, THE VILLAGES, FL 32162-1004
(352) 259-4705
Mailing address
631 ALLENWOOD LOOP, THE VILLAGES, FL 32162-1004
(352) 259-4705

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
ARNP 1829532
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2007000083-23
ANCC GERI. BD. CERT.
01
AG81OZ
MEDICARE PTAN
FL
01
ARNP 1829532
ARNP LICENSE NUMBER
FL
Enumeration date
04/16/2007
Last updated
06/17/2011
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