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General NPI Number Information
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NPI Number | 1083694913
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Entity Type | Individual
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Provider Name | ELAINE GAIL LANGE R.N, A.P.N.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 485 WILLIAMSTOWN RD
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-1777
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Country | US
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Telephone | 856-227-6575
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Fax | 856-237-8042
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Provider Business Mailing Address
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Address Line | 402 LIPPINCOTT DR
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City | MARLTON
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State | NJ
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Zip | 08053-4112
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Country | US
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Telephone | 856-782-3300
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Fax | 856-504-8029
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NN08298500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | NO08298500
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License Number State | NJ
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