Provider Demographics
NPI:1083379127
Name:LANGHAM, JENNIFER ANN (RN, ACNPC-AG)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:LANGHAM
Suffix:
Gender:F
Credentials:RN, ACNPC-AG
Other - Prefix:
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Mailing Address - Street 1:1155 MILL ST
Mailing Address - Street 2:MS M14
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-4196
Practice Address - Street 1:1155 MILL ST
Practice Address - Street 2:MS W14
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1576
Practice Address - Country:US
Practice Address - Phone:775-982-7878
Practice Address - Fax:775-982-4196
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2022-03-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV838434363LA2200X, 363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology