Provider Demographics
NPI:1033116314
Name:LANG, LINDSAY W (NP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:W
Last Name:LANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3407
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47733-3407
Mailing Address - Country:US
Mailing Address - Phone:812-473-1737
Mailing Address - Fax:812-473-2432
Practice Address - Street 1:7307 E COLUMBIA ST
Practice Address - Street 2:STE 101
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-9141
Practice Address - Country:US
Practice Address - Phone:812-473-1737
Practice Address - Fax:812-473-2432
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000963A363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200332560Medicaid
IN193430BMedicare ID - Type Unspecified
IN200332560Medicaid