Provider Demographics
NPI:1275627416
Name:LANGDON, THERESE ANN (RN BSN CWON)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:ANN
Last Name:LANGDON
Suffix:
Gender:F
Credentials:RN BSN CWON
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:26916 EASTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1151
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:121-679-1380
Practice Address - Fax:121-642-1303
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 193302163WE0900X
OHRN.193302163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
Not Answered163WW0000XNursing Service ProvidersRegistered NurseWound Care