Provider Demographics
NPI:1699904128
Name:LANDE, NANCY IDELL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:IDELL
Last Name:LANDE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12012 MONTROSE VILLAGE TER
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4162
Mailing Address - Country:US
Mailing Address - Phone:410-531-6361
Mailing Address - Fax:
Practice Address - Street 1:12012 MONTROSE VILLAGE TER
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4162
Practice Address - Country:US
Practice Address - Phone:410-531-6361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD129121835G0303X
ORRPH00106081835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric