Healthcare Provider Details

I. General information

NPI: 1295936532
Provider Name (Legal Business Name): KARL WILLIAM LANG JR. MSN, FNP-BC, CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 03/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

958 E ORANGE ST
LANCASTER PA
17602-3214
US

IV. Provider business mailing address

958 E ORANGE ST
LANCASTER PA
17602-3214
US

V. Phone/Fax

Practice location:
  • Phone: 717-575-7895
  • Fax:
Mailing address:
  • Phone: 717-575-7895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP011170
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN563119
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: