Provider Demographics
NPI:1053485730
Name:LANDY, COLLEEN ELIZABETH (MGC)
Entity Type:Individual
Prefix:MISS
First Name:COLLEEN
Middle Name:ELIZABETH
Last Name:LANDY
Suffix:
Gender:F
Credentials:MGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CRYSTAL OAKS CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-9789
Mailing Address - Country:US
Mailing Address - Phone:443-310-5488
Mailing Address - Fax:
Practice Address - Street 1:201 SAGE RD STE 300
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-6510
Practice Address - Country:US
Practice Address - Phone:919-942-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS