Provider Demographics
NPI:1952193930
Name:LANDON, ALICIA MICHELLE (LPN II)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:MICHELLE
Last Name:LANDON
Suffix:
Gender:F
Credentials:LPN II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 FARMER ST
Mailing Address - Street 2:
Mailing Address - City:STARR
Mailing Address - State:SC
Mailing Address - Zip Code:29684-8923
Mailing Address - Country:US
Mailing Address - Phone:601-342-7798
Mailing Address - Fax:
Practice Address - Street 1:518 FARMER ST
Practice Address - Street 2:
Practice Address - City:STARR
Practice Address - State:SC
Practice Address - Zip Code:29684-8923
Practice Address - Country:US
Practice Address - Phone:601-342-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC54084164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse