Healthcare Provider Details

I. General information

NPI: 1578064473
Provider Name (Legal Business Name): REBECCA LANGLEY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 03/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 POND RD STE 300
ALLENTOWN PA
18104-2258
US

IV. Provider business mailing address

PO BOX 783311
PHILADELPHIA PA
19178-3311
US

V. Phone/Fax

Practice location:
  • Phone: 610-398-7700
  • Fax: 610-398-6917
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW010512
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: