Individual
THERESA E LANDRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2400 AVALON AVE, MUSCLE SHOALS, AL 35661
(256) 386-0808
(256) 389-8904
Mailing address
2400 AVALON AVE, MUSCLE SHOALS, AL 35661-3164
(256) 386-0808
(256) 389-8904
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1030759
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051119112
BLUECROSS
AL
Enumeration date
09/25/2006
Last updated
06/21/2018
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