Individual
STEPHANIE D LANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
192 BACON CREEK RD, CORBIN, KY 40701-8639
(606) 526-1900
Mailing address
106 OLD WOOLDRIDGE PIKE, JELLICO, TN 37762-3518
(423) 201-3161
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
24514
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
3014119
KY
Other
Enumeration date
08/08/2018
Last updated
02/19/2020
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