Active NPI
Angela Landry
- Nurse Practitioner
- Grand Blanc, MI
National Provider Identifier
1063379014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704383685
- Practice address
- 3139 E Baldwin Rd
Grand Blanc, MI 48439-7374 - Phone
- (810) 445-5300
- NPI assigned
- Jan 9, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704383685 | MI | Primary |
Addresses
Primary practice location
3139 E Baldwin Rd
Grand Blanc, MI 48439-7374
Mailing address
3139 E Baldwin Rd
Grand Blanc, MI 48439-7374
Phone (810) 445-5300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704383685 | MI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781481600000",
"number": "1063379014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3139 E BALDWIN RD",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484397374",
"telephone_number": "810-445-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3139 E BALDWIN RD",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484397374",
"telephone_number": "810-445-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDRY",
"first_name": "ANGELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-01-09",
"last_updated": "2026-06-15",
"certification_date": "2026-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704383685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Blanc, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.