Provider Demographics
NPI:1235201419
Name:LANGLOIS, DIANE M (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:M
Last Name:LANGLOIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 BORTHWICK AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7128
Mailing Address - Country:US
Mailing Address - Phone:603-431-5858
Mailing Address - Fax:603-431-5818
Practice Address - Street 1:333 BORTHWICK AVE STE 301
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7128
Practice Address - Country:US
Practice Address - Phone:603-431-5858
Practice Address - Fax:603-431-5818
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH027358363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3077765Medicaid
NH0422560001Medicare NSC
NHLANP3594Medicare PIN
P44540Medicare UPIN
4687OtherCIGNA NH
NHLANP3594Medicare PIN
P44540Medicare UPIN
NH0422560001Medicare NSC