Healthcare Provider Details

I. General information

NPI: 1275524639
Provider Name (Legal Business Name): BRIDGET A LANGA A.P.R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CORDAGE PARK CIR STE 115
PLYMOUTH MA
02360-7318
US

IV. Provider business mailing address

10 CORDAGE PARK CIR STE 115
PLYMOUTH MA
02360-7318
US

V. Phone/Fax

Practice location:
  • Phone: 508-778-5470
  • Fax: 508-778-5471
Mailing address:
  • Phone: 508-778-5470
  • Fax: 508-778-5471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number044233-23
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number216603
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: