MEDICARE: KRISTIN MARIE LANGE

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	367500000X	Certified Registered Nurse Anesthetist	101972	NE

General Provider Information

NPI Number	:	1508737537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN MARIE LANGE

Provider Business Mailing Address
First Line	:	7801 WAKELEY PLZ
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-3651
Country	:	US
Telephone Number	:	402-391-4855
Fax Number	:	402-391-6818

Provider Business Practice Location Address
First Line	:	8303 DODGE ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-4108
Country	:	US
Telephone Number	:	402-391-4855
Fax Number	:	402-391-6818

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

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	01/20/2026

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Directions to “ KRISTIN MARIE LANGE ” Practice Location

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