Provider Demographics
NPI:1235497686
Name:LANGE, RHONDA DORIS (APRN)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:DORIS
Last Name:LANGE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15720 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:NE
Mailing Address - Zip Code:68428-4164
Mailing Address - Country:US
Mailing Address - Phone:402-785-2446
Mailing Address - Fax:402-785-2446
Practice Address - Street 1:15720 N 1ST ST
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NE
Practice Address - Zip Code:68428-4164
Practice Address - Country:US
Practice Address - Phone:402-785-2446
Practice Address - Fax:402-785-2446
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111340363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology