Provider Demographics
NPI:1033777438
Name:THOMAS-LANGFORD, MERYLL GUILLORY (APRNCNM)
Entity Type:Individual
Prefix:MRS
First Name:MERYLL
Middle Name:GUILLORY
Last Name:THOMAS-LANGFORD
Suffix:
Gender:F
Credentials:APRNCNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 CLIFTON AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-3041
Mailing Address - Country:US
Mailing Address - Phone:513-751-5900
Mailing Address - Fax:
Practice Address - Street 1:3219 CLIFTON AVE STE 210
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3041
Practice Address - Country:US
Practice Address - Phone:513-751-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013521367A00000X
OHAPRN.CNM.019432367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife