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General NPI Number Information
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NPI Number | 1770885345
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Entity Type | Individual
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Provider Name | ANGELA J LANG ARNP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 02/15/2013
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Provider Practice Location Address
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Address Line | 126 PORTMAN AVE
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City | STANFORD
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State | KY
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Zip | 40484-1230
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Country | US
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Telephone | 606-365-9181
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Fax | 606-365-9183
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Provider Business Mailing Address
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Address Line | 126 PORTMAN AVE
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City | STANFORD
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State | KY
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Zip | 40484-1230
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Country | US
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Telephone | 606-365-9181
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Fax | 606-365-9183
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3006568
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License Number State | KY
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