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NPI Code Detail

MEDICARE: SAMANTHA MARY GIMELLI LANGE FNP-C

MEDICARE: SAMANTHA MARY GIMELLI LANGE FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN.1628476CO
2363LF0000XFamily Nurse PractitionerAPN.0996681-NPCO
3363LP0200XPediatric Nurse PractitionerAPN.0996681-NPCO

General Provider Information

NPI Number : 1023781523
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA MARY GIMELLI LANGE FNP-C
Provider Business Mailing Address
First Line : 26229 E MAPLE DR
Second Line :
City : AURORA
State : CO
Zip : 80018-4671
Country : US
Telephone Number : 720-939-0605
Fax Number :
Provider Business Practice Location Address
First Line : 1775 AURORA CT RM 2404
Second Line :
City : AURORA
State : CO
Zip : 80045-2536
Country : US
Telephone Number : 303-724-7514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2021
Last Update Date : 01/05/2022

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