Provider Demographics
NPI:1245209683
Name:LANGSTON, MARY ANN FLOYD (ANP)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:FLOYD
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST
Mailing Address - Street 2:SLOT #783
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-614-2125
Mailing Address - Fax:501-526-6562
Practice Address - Street 1:4301 W MARKHAM ST
Practice Address - Street 2:SLOT #783
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-614-2125
Practice Address - Fax:501-526-6562
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01846363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00220686OtherMEDICARE RAILROAD
ARP00220686OtherMEDICARE RAILROAD
AR5Y306Medicare PIN