Healthcare Provider Details

I. General information

NPI: 1043822794
Provider Name (Legal Business Name): DANIELLE LANGER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2020
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 W MAIN ST
NORWICH CT
06360-5415
US

IV. Provider business mailing address

372 W MAIN ST
NORWICH CT
06360-5415
US

V. Phone/Fax

Practice location:
  • Phone: 860-887-5970
  • Fax:
Mailing address:
  • Phone: 860-887-5970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9130
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: