Provider Demographics
NPI:1144482456
Name:CRANSTOUN, LANDI MARIE (MD)
Entity type:Individual
Prefix:
First Name:LANDI
Middle Name:MARIE
Last Name:CRANSTOUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LANDI
Other - Middle Name:M
Other - Last Name:PARISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:496 SOUTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1827
Mailing Address - Country:US
Mailing Address - Phone:859-288-2392
Mailing Address - Fax:859-721-3918
Practice Address - Street 1:103 ALYCIA DR STE 2
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2368
Practice Address - Country:US
Practice Address - Phone:606-330-7818
Practice Address - Fax:606-330-7825
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-02032207Q00000X
KY47874207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100364840Medicaid