Healthcare Provider Details

I. General information

NPI: 1851365092
Provider Name (Legal Business Name): CHRISTINE MARIE LANGAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 827 BOX 1000
FPO AE
09617
IT

IV. Provider business mailing address

PSC 827 BOX 218
FPO AE
09617
IT

V. Phone/Fax

Practice location:
  • Phone: 81-811-6426
  • Fax:
Mailing address:
  • Phone: 81-811-6426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number13956
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: