Provider Demographics
NPI:1871140392
Name:LANDERS, ABBY KOLB (RN)
Entity type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:KOLB
Last Name:LANDERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:KOLB
Other - Last Name:DURAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-3214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 RIVER ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-3214
Practice Address - Country:US
Practice Address - Phone:401-529-0414
Practice Address - Fax:401-921-6190
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN55826163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse