Provider Demographics
NPI:1134687429
Name:O'STEEN, LANDON MICHAEL
Entity Type:Individual
Prefix:
First Name:LANDON
Middle Name:MICHAEL
Last Name:O'STEEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 CHAMPAGNE CIR
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-6727
Mailing Address - Country:US
Mailing Address - Phone:417-849-9404
Mailing Address - Fax:
Practice Address - Street 1:575 CHAMPAGNE CIR
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-6727
Practice Address - Country:US
Practice Address - Phone:417-849-9404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program