Healthcare Provider Details

I. General information

NPI: 1649001058
Provider Name (Legal Business Name): MEGAN ELIZABETH LANG FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 REYNOLDS ST STE 201
SAVANNAH GA
31405-6087
US

IV. Provider business mailing address

836 E 65TH ST STE 22
SAVANNAH GA
31405-4493
US

V. Phone/Fax

Practice location:
  • Phone: 912-355-5755
  • Fax: 912-355-5759
Mailing address:
  • Phone: 912-819-7171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN222458
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: