Provider Demographics
NPI:1083763767
Name:LANGSTEN, NELS KURT (MD)
Entity Type:Individual
Prefix:DR
First Name:NELS
Middle Name:KURT
Last Name:LANGSTEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:874 CHIPPEWA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-3552
Mailing Address - Country:US
Mailing Address - Phone:651-222-3400
Mailing Address - Fax:651-602-9365
Practice Address - Street 1:400 SELBY AVE
Practice Address - Street 2:SUITE G-4
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-4508
Practice Address - Country:US
Practice Address - Phone:646-752-2078
Practice Address - Fax:651-602-9365
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2011-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN177392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN845219900Medicaid