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General NPI Number Information
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NPI Number | 1437517877
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Entity Type | Individual
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Provider Name | AMBER NICOLE LANGSTON PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/31/2016
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1500 S WATSON RD STE C104
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City | BUCKEYE
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State | AZ
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Zip | 85326-8689
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Country | US
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Telephone | 623-251-7559
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Fax |
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Provider Business Mailing Address
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Address Line | 129 N 175TH AVE
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City | GOODYEAR
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State | AZ
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Zip | 85338-4894
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Country | US
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Telephone | 907-792-9435
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 11071
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 106230
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License Number State | AK
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