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NPI Code Detail

MEDICARE: AMY S LANGE CNM

MEDICARE:   AMY S LANGE  CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice MidwifeR1113365MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
107-00775OTHERMEDICA
21019218OTHERPREFERRED ONE
3930063OTHERAMERICA'S PPO (ARAZ)
4HP22762OTHERHEALTH PARTNERS
537B63LAOTHERMNBCBS MN
6109104OTHERUCARE
732427OTHERSIOUX VALLEY HEALTH PLAN

General Provider Information

NPI Number : 1528038106
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY S LANGE CNM
Provider Business Mailing Address
First Line : 4043 COLFAX AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55409-1425
Country : US
Telephone Number : 612-822-8136
Fax Number :
Provider Business Practice Location Address
First Line : 1200 LAGOON AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-2077
Country : US
Telephone Number : 612-823-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 07/08/2007

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Directions to “ AMY S LANGE CNM” Practice Location

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