Healthcare Provider Details

I. General information

NPI: 1497732309
Provider Name (Legal Business Name): LYNN MARIE LANGSFORD ARNP CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6002 N WESTGATE BLVD STE 230
TACOMA WA
98406
US

IV. Provider business mailing address

6002 N WESTGATE BLVD STE 230
TACOMA WA
98406
US

V. Phone/Fax

Practice location:
  • Phone: 253-761-2244
  • Fax: 253-761-1040
Mailing address:
  • Phone: 253-761-2244
  • Fax: 253-761-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00074183
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number025804 AP30001892
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number025804 AP30001892
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: