Healthcare Provider Details

I. General information

NPI: 1831280817
Provider Name (Legal Business Name): KATHLEEN LANGDON PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6920 VAN DORN ST SUITE B
LINCOLN NE
68506-2842
US

IV. Provider business mailing address

6901 HAVELOCK AVE
LINCOLN NE
68507-1440
US

V. Phone/Fax

Practice location:
  • Phone: 402-476-7557
  • Fax:
Mailing address:
  • Phone: 402-730-4289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN TERESE LANGDON
Title or Position: OWNER
Credential: APRN
Phone: 402-730-4289