Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | TM2010-0152 | NM |
Y | 2084N0600X | Clinical Neurophysiologist | DR0052714 | CO |
NPI | 1043345861 |
---|---|
Provider Name | Dr. Barbara Anne Landesman |
First Address | Longmont, CO 80504-7805 |
Second Address | Longmont, CO 80504-7805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 03/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00933330 | (05) | CA |
A93333 | LICENSE (01) | CA |
FL 1687118 | DEA (01) | CA |
I71742 | (02) | CA |
TM2010-0152 | NM (01) | NM |