MEDICARE: RENEE ANN LANGBEIN IDC

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
1	1710I1002X	Independent Duty Corpsman

General Provider Information

NPI Number	:	1184811820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RENEE ANN LANGBEIN IDC

Provider Business Mailing Address
First Line	:	USS JOHN C. STENNIS CVN 74
Second Line	:	MEDICAL DEPARTMENT BOX 67
City	:	FPO
State	:	AP
Zip	:	96615-2874
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	USS JOHN C. STENNIS CVN 74
Second Line	:	MEDICAL DEPARTMENT BOX 67
City	:	FPO
State	:	AP
Zip	:	96615-2874
Country	:	US
Telephone Number	:	13606272562
Fax Number	:	13606272562

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	03/16/2010

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