Provider Demographics
NPI:1710735105
Name:LANDAHL, JOHANA MELISA (DNP, FNP-BC, APRN)
Entity type:Individual
Prefix:
First Name:JOHANA
Middle Name:MELISA
Last Name:LANDAHL
Suffix:
Gender:F
Credentials:DNP, FNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 SPRUCE MOUNTAIN WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6017
Mailing Address - Country:US
Mailing Address - Phone:702-824-7001
Mailing Address - Fax:
Practice Address - Street 1:6655 W SAHARA AVE STE D104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0846
Practice Address - Country:US
Practice Address - Phone:725-217-4231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV814768363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily