Provider Demographics
NPI:1134108699
Name:LANGBEHN, JANE A (CNP)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:A
Last Name:LANGBEHN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:A
Other - Last Name:GLANZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:PO BOX 2760
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57709-2760
Mailing Address - Country:US
Mailing Address - Phone:605-343-1333
Mailing Address - Fax:605-343-6017
Practice Address - Street 1:2908 5TH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7317
Practice Address - Country:US
Practice Address - Phone:605-343-1333
Practice Address - Fax:605-343-6017
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR024145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6825150Medicaid
SD4995992OtherWELLMARK NUMBER
SDP00078798OtherRAILROAD MEDICARE
SDP00078798OtherRAILROAD MEDICARE
SDP98467Medicare UPIN
SDS41475Medicare ID - Type UnspecifiedMEDICARE NUMBER