Provider Demographics
NPI:1033682711
Name:LANGENHOVEN, ANNEKE
Entity Type:Individual
Prefix:
First Name:ANNEKE
Middle Name:
Last Name:LANGENHOVEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 BESTGATE RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3404
Mailing Address - Country:US
Mailing Address - Phone:410-224-2116
Mailing Address - Fax:410-224-2118
Practice Address - Street 1:820 BESTGATE RD STE 2A
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3404
Practice Address - Country:US
Practice Address - Phone:102-242-1164
Practice Address - Fax:410-224-2118
Is Sole Proprietor?:No
Enumeration Date:2019-01-06
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR204490363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care