Provider Demographics
NPI:1841887874
Name:LANDSMAN, NANCY EILEEN
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:EILEEN
Last Name:LANDSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6654 WIND RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-7477
Mailing Address - Country:US
Mailing Address - Phone:301-788-3400
Mailing Address - Fax:
Practice Address - Street 1:1 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5677
Practice Address - Country:US
Practice Address - Phone:301-831-7111
Practice Address - Fax:410-549-7627
Is Sole Proprietor?:No
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10577183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist