Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 30567 | KY |
NPI | 1003854696 |
---|---|
Provider Name | Gina L Land |
First Address | Richmond, KY 40475-2406 |
Second Address | Richmond, KY 40475-2406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000215093 | ANTHEM BCBS (01) | KY |
1482851 | UNITED HEALTH CARE (01) | KY |
160057188 | RAILROAD MEDICARE (01) | KY |
364489332 | TAX ID # (01) | KY |
5533687 | AETNA (01) | KY |
6430567500 | (05) | KY |
G52112 | (02) | KY |