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NPI Code Detail

MEDICARE: SUSAN LOUISE LANG PMHNP-BC

MEDICARE: SUSAN LOUISE LANG PMHNP-BC
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
1163WP0808XPsychiatric/Mental Health Registered NurseRN152597GA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerRN152597GA

General Provider Information

NPI Number : 1467047639
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN LOUISE LANG PMHNP-BC
Provider Business Mailing Address
First Line : 1325 SATELLITE BLVD NW STE 400
Second Line :
City : SUWANEE
State : GA
Zip : 30024-5299
Country : US
Telephone Number : 678-263-3080
Fax Number :
Provider Business Practice Location Address
First Line : 1325 SATELLITE BLVD NW STE 400
Second Line :
City : SUWANEE
State : GA
Zip : 30024-5299
Country : US
Telephone Number : 678-263-3080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2021
Last Update Date : 07/06/2021

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Directions to “ SUSAN LOUISE LANG PMHNP-BC” Practice Location

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