Jerid Land
Individual provider Active NPI Emergency Registered Nurse · Houston, MO
NPI 1891456059 · NPPES record last updated May 25, 2023
Key facts
- NPI
- 1891456059
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Registered Nurse 163WE0003X
- License
- 2020012036 (MO)
- Practice address
- 1333 S Sam Houston Blvd
Houston, MO 65483-2046 - Phone
- (573) 529-9355
- NPI assigned
- Jan 10, 2022
- Sex
- Male
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020012036 | MO | MD | Emergency Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | 2020012036 | MO | Yes |
| Registered Nurse | 163W00000X | 2020012036 | MO |
Addresses
Primary practice location
1333 S Sam Houston Blvd
Houston, MO 65483-2046
Mailing address
452 County Road 5110
Salem, MO 65560-8289
Phone (573) 529-9355
Other providers in Houston, MO
- Steven Charles Hutcheson
- Dara Jackson
- Selina A Jeanise
- Rachel Johnson
- Sierra Keller
- Carl W Lange IV
- Jennifer Renee Leggins
- Lester E Cox Medical Centers
- Jason Matthew Loden
- Teresa Lorraine Loden
All providers in Houston, MO · Emergency Registered Nurse in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2023. 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.