LANDERMA NPI 1215779020

NPI Information

  • NPI: 1215779020
  • Provider Name: LANDERMA
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Address: 4494 W PEORIA AVE STE 115A RM 18
    GLENDALE, AZ
    ZIP 85302
  • Phone: (480) 809-1351

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NPI Details

LANDERMA is a family nurse practitioner in Glendale, AZ. LANDERMA NPI is 1215779020. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4494 W PEORIA AVE STE 115A RM 18
GLENDALE, AZ
ZIP 85302
Phone: (480) 809-1351
Fax: (623) 321-7259

The provider's authorized official is Joseph Emmanuel Gallardo .
The authorized official title is Nurse Practitioner and has the following contact phone number (480) 809-1351.

The enumeration date for this NPI number is 6/11/2024 and was last updated on 6/11/2024.

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
1363LF0000XNurse PractitionerFamilyYes

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: 3/30/2025

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