Provider Demographics
NPI:1053983635
Name:LANDIS, JOSHUA LEE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:LEE
Last Name:LANDIS
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746550
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6550
Mailing Address - Country:US
Mailing Address - Phone:888-236-2263
Mailing Address - Fax:434-975-1183
Practice Address - Street 1:3263 PROFFIT RD STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911
Practice Address - Country:US
Practice Address - Phone:434-654-4600
Practice Address - Fax:434-975-1834
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VAF07210602363LF0000X
VA0024182336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily