Individual
ROBERT KEITH LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
8292 S RIDGE DR, MACUNGIE, PA 18062-9138
(610) 966-3163
Mailing address
8292 S RIDGE DR, MACUNGIE, PA 18062-9138
(610) 966-3163
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-254765L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
041740
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1579397
HIGHMARK
PA
01
—
2258727000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
06/12/2006
Last updated
10/19/2007
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