Provider Demographics
NPI:1376716852
Name:LANDAU, KAREN ANN (RN, APN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:LANDAU
Suffix:
Gender:F
Credentials:RN, APN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:LANDAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2669 KILLIAN PL
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6503
Mailing Address - Country:US
Mailing Address - Phone:908-688-0409
Mailing Address - Fax:
Practice Address - Street 1:2669 KILLIAN PL
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6503
Practice Address - Country:US
Practice Address - Phone:908-688-0409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00018800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P70392Medicare UPIN