MEDICARE: MRS. CARRIE LYNN LANGLEY F.N.P. 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
1	363LF0000X	Family Nurse Practitioner	4704208018	MI

General Provider Information

NPI Number	:	1871993147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARRIE LYNN LANGLEY F.N.P. BC

Provider Business Mailing Address
First Line	:	1409 MIDLAND RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9474
Country	:	US
Telephone Number	:	989-214-0153
Fax Number	:	989-269-7490

Provider Business Practice Location Address
First Line	:	1142 S VAN DYKE RD
Second Line	:
City	:	BAD AXE
State	:	MI
Zip	:	48413-9800
Country	:	US
Telephone Number	:	989-269-7445
Fax Number	:	989-269-7490

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

Provider Enumeration Date	:	08/24/2014
Last Update Date	:	12/20/2024

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