Provider Demographics
NPI:1316190549
Name:LANDO, JANE LOUISE (RPH)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:LOUISE
Last Name:LANDO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 966
Mailing Address - Street 2:
Mailing Address - City:NOME
Mailing Address - State:AK
Mailing Address - Zip Code:99762-0966
Mailing Address - Country:US
Mailing Address - Phone:907-443-3319
Mailing Address - Fax:907-443-2847
Practice Address - Street 1:306 W 5TH AVE.
Practice Address - Street 2:
Practice Address - City:NOME
Practice Address - State:AK
Practice Address - Zip Code:99762-0966
Practice Address - Country:US
Practice Address - Phone:907-443-3319
Practice Address - Fax:907-443-2847
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist