=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922037175
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL R LANGAN II CRNA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/01/2006
-----------------------------------------------------
Last Update Date | 10/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 707 14TH ST
-----------------------------------------------------
City | BARABOO
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53913-1539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-356-1400
-----------------------------------------------------
Fax | 608-356-1367
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | W9899 COUNTY ROAD X
-----------------------------------------------------
City | PORTAGE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53901-8805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-697-4277
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | 154282030
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------