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General NPI Number Information
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NPI Number | 1811313547
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Entity Type | Individual
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Provider Name | KAREN LANGE
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Gender | Female
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Dates
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Enumeration Date | 03/05/2014
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 2400 W MARKHAM ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-6129
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Country | US
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Telephone | 501-324-9522
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Fax |
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Provider Business Mailing Address
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Address Line | 385 S 17TH ST
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City | BATESVILLE
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State | AR
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Zip | 72501-4712
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Country | US
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Telephone | 870-613-1067
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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