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General NPI Number Information
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NPI Number | 1083379127
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Entity Type | Individual
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Provider Name | JENNIFER ANN LANGHAM RN, ACNPC-AG
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Gender | Female
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 6880 S MCCARRAN BLVD STE 5
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City | RENO
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State | NV
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Zip | 89509-6129
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Country | US
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Telephone | 775-398-1981
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Fax | 775-398-1984
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Provider Business Mailing Address
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Address Line | PO BOX 511360
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City | LOS ANGELES
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State | CA
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Zip | 90051-7915
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Country | US
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Telephone | 775-398-1981
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Fax | 775-398-1984
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 838434
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License Number State | NV
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