Provider Demographics
NPI:1053102871
Name:LANDERS, VINCENT P I
Entity type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:P
Last Name:LANDERS
Suffix:I
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 1:4706 CASS ST APT 6
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-3039
Mailing Address - Country:US
Mailing Address - Phone:402-596-5608
Mailing Address - Fax:
Practice Address - Street 1:4706 CASS ST APT 6
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68132-3039
Practice Address - Country:US
Practice Address - Phone:402-596-5608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider