Provider Demographics
NPI:1639348394
Name:LANDRY, ANNA CRISTINE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:CRISTINE
Last Name:LANDRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:CRISTINE
Other - Last Name:MCFATTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:501 DR MICHAEL DEBAKEY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5724
Mailing Address - Country:US
Mailing Address - Phone:337-312-8258
Mailing Address - Fax:337-312-6708
Practice Address - Street 1:600 DR MICHAEL DEBAKEY DR
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5727
Practice Address - Country:US
Practice Address - Phone:337-436-3813
Practice Address - Fax:337-493-4325
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05420363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1049042Medicaid
LA1049042Medicaid
LAP01140666Medicare PIN
LA261629YH5NMedicare PIN
LA3A613D048Medicare PIN