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January Marie Landaeta

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as JANUARY LANDAETA.

Based on the most recent information from CMS, provider January Marie Landaeta is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1538576889
Provider Type
Individual
Full Name
Landaeta, January Marie
Gender
Female

Sole Proprietor
No
Enumeration Date
7/18/2014
Last Updated
9/9/2024

Contact Information

Practice Location

926 Main St, Nashville, TN 37206-3614

(615) 436-9060

(615) 235-9725

Mailing Location

926 Main St, Nashville, TN 37206-3614

(615) 585-1181

(615) 235-9725

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License APRN9265970 Florida
Code 163WG0000X	Description Registered Nurse Nursing Service Providers	License ARNP 9265970 Florida

January Marie Landaeta

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Moore, Tiffany

Hannah, Julie

Wildeman, Mary

Allan, Promise C

Glass, Jody Lynn

Wiseman, Summer

Murphy, Brandi Me'Chelle

Rivera, Maria Alejandra

Hammond, Piper Leigh

Moore, Seresa