Provider Demographics
NPI:1225896012
Name:LANG, VICTORIA RENEE
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:RENEE
Last Name:LANG
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 1:401 N MILDRED ST
Mailing Address - Street 2:
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-1525
Mailing Address - Country:US
Mailing Address - Phone:304-240-1322
Mailing Address - Fax:
Practice Address - Street 1:401 N MILDRED ST
Practice Address - Street 2:
Practice Address - City:RANSON
Practice Address - State:WV
Practice Address - Zip Code:25438-1525
Practice Address - Country:US
Practice Address - Phone:304-240-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty