Provider Demographics
NPI:1275507022
Name:LANDY, JANICE A (MD)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:A
Last Name:LANDY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 SE DELAWARE AVE STE G-#277
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4767
Mailing Address - Country:US
Mailing Address - Phone:515-514-1186
Mailing Address - Fax:515-514-1169
Practice Address - Street 1:1701 48TH ST STE 110
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6723
Practice Address - Country:US
Practice Address - Phone:515-514-1186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA395922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN400618600Medicaid
F84328Medicare UPIN
MN400618600Medicaid