Provider Demographics
NPI:1164310041
Name:LAND, ADRIENNE LANORMA (PMHNP)
Entity type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:LANORMA
Last Name:LAND
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10116 BULL RUN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-7386
Mailing Address - Country:US
Mailing Address - Phone:469-767-3530
Mailing Address - Fax:469-767-3530
Practice Address - Street 1:1604 HOSPITAL PKWY STE 507
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6933
Practice Address - Country:US
Practice Address - Phone:817-354-7268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2025024363363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health