Dienna Louise Landis, CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

NP08479 Issued in OH

Practice address

2249 Elm Road Ext
Cortland, OH 44410

Phone

(330) 372-1608

Fax

(330) 372-1633

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Dienna Louise Dickson Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154480556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9394 ST RT 7",
            "city": "KINSMAN",
            "state": "OH",
            "postal_code": "44428",
            "telephone_number": "330-876-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2249 ELM ROAD EXT",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "44410",
            "telephone_number": "330-372-1608",
            "fax_number": "330-372-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIS",
        "first_name": "DIENNA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "NP08479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2631996",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIENNA",
            "last_name": "DICKSON",
            "middle_name": "LOUISE",
            "prefix": "MISS",
            "credential": "CNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Adult Health Nurse Practitioner in Cortland, OH
• Providers in Cortland, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.