Healthcare Provider Details

I. General information

NPI: 1710716543
Provider Name (Legal Business Name): CORINNE LANGE APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORINNE DROESSLER

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

169 MADISON AVE STE 38114
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-3310
  • Fax: 414-805-3885
Mailing address:
  • Phone: 646-876-8455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15674
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTPAN4904
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number91865
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number60129
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: