MRS. LANDON EIREEN PETTIT A-GNP-C NPI 1205392560

NPI Information

NPI: 1205392560
Provider Name: MRS. LANDON EIREEN PETTIT, A-GNP-C
Classification: Internal Medicine - 207RG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

Organization: COMMUNITY MEDICAL GROUP LLC

PECOS Registration: Yes

Address:
603 28 1/4 RD
GRAND JCT, CO
ZIP 81506
Phone: (970) 263-2600
Get Directions

MRS. Landon Eireen Pettit, A-GNP-C is a geriatric medicine internal medicine in Grand Jct, CO with 6 years of experience. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. MRS. Landon Eireen Pettit, A-GNP-C NPI is 1205392560. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

603 28 1/4 RD
GRAND JCT, CO
ZIP 81506-019
Phone: (970) 263-2600
Fax: (970) 263-2692

The NPI 1205392560 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/12/2019 and was last updated on 6/4/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	APN.0995293-NP	COLORADO	No
2	207RG0300X	Internal Medicine	Geriatric Medicine	APN.0995293-NP	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RXN.0104530-NP	OTHER	COLORADO	CO RXN
2	APN.0995293	OTHER	COLORADO	COLORADO LICENSE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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