MEDICARE: TINA LANGERAAP MARTIN P.A.

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
1	363A00000X	Physician Assistant	PA851	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA851	OTHER	NV	NV PA LICENSE

General Provider Information

NPI Number	:	1952494619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA LANGERAAP MARTIN P.A.

Provider Business Mailing Address
First Line	:	1802 N CARSON ST
Second Line	:	SUITE 100
City	:	CARSON CITY
State	:	NV
Zip	:	89701-1265
Country	:	US
Telephone Number	:	775-888-6610
Fax Number	:	775-887-7046

Provider Business Practice Location Address
First Line	:	1312 E TONOPAH AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-7111
Country	:	US
Telephone Number	:	702-399-4791
Fax Number	:	702-399-1547

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	12/20/2009

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Directions to “ TINA LANGERAAP MARTIN P.A.” Practice Location

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