Provider Demographics
NPI:1104345180
Name:LANDON, LAURA FOX (CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:FOX
Last Name:LANDON
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:KATHERINE
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-PC
Mailing Address - Street 1:530 W WEBB AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-3706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:530 W WEBB AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-3706
Practice Address - Country:US
Practice Address - Phone:336-228-8316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC254734363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics