Andrea M Landis, PHD, RN, FNP
Individual provider Active NPI Family Nurse Practitioner · Manassas Park, VA
NPI 1104496389 · NPPES record last updated Jun 29, 2021
Key facts
- NPI
- 1104496389
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024164141 (VA)
- Practice address
- 99 Tremont St
Manassas Park, VA 20111-1800 - Phone
- (703) 993-5880
- NPI assigned
- Jun 29, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024164141 | VA | MD | Family Nurse Practitioner |
Interoperability endpoints
- andrea.landis.1@29379.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024164141 | VA | Yes |
Addresses
Primary practice location
99 Tremont St
Manassas Park, VA 20111-1800
Mailing address
344 Maple Ave W # 128
Vienna, VA 22180-5612
Phone (206) 499-5390
Other providers in Manassas Park, VA
- Joseph M. Arzadon, MD, DDS, PC
- Abigail Kassa
- Kent Village Medical Center, LLC
- Edward S Kim
- Kennedy Kingston
- Lisa Lowe
- Manassas Park City Schools
- Diona Martyn
- Benjamin Luke McDaniel
- Donna Marie McGarr
All providers in Manassas Park, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.