Provider Demographics
NPI:1215265673
Name:LANDERS, SUSAN DAWN (RN BSN)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:DAWN
Last Name:LANDERS
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Gender:F
Credentials:RN BSN
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Mailing Address - Street 1:550 POPE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66027-2332
Mailing Address - Country:US
Mailing Address - Phone:913-684-6769
Mailing Address - Fax:913-684-6766
Practice Address - Street 1:550 POPE AVE.
Practice Address - Street 2:MUNSON ARMY HEALTH CENTER ATTN: MCXN-COD, MR. KENNEDY
Practice Address - City:FORT LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66027-2332
Practice Address - Country:US
Practice Address - Phone:913-684-6143
Practice Address - Fax:913-684-6208
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2024-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS13-127884-041163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management