MR. MARK J LANDRY NP NPI 1679518823

NPI Information

  • NPI: 1679518823
  • Provider Name: MR. MARK J LANDRY, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3621 AMBASSADOR CAFFERY PKWY STE 100
    LAFAYETTE, LA
    ZIP 70503
  • Phone: (337) 534-4410

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NPI Details

MR. Mark J Landry, NP is a family nurse practitioner in Lafayette, LA with 22 years of experience. MR. Mark J Landry, NP NPI is 1679518823. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3621 AMBASSADOR CAFFERY PKWY STE 100
LAFAYETTE, LA
ZIP 70503-132
Phone: (337) 534-4410

The NPI 1679518823 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 6/19/2006 and was last updated on 2/17/2023.

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
1207P00000XEmergency MedicineRN095042LOUISIANANo
2363LF0000XNurse PractitionerFamilyAP04519LOUISIANAYes

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
11467430MEDICAIDLOUISIANA

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: 11/21/2025

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