Provider Demographics
NPI:1275800989
Name:LANGE, KAY L (RN)
Entity Type:Individual
Prefix:
First Name:KAY
Middle Name:L
Last Name:LANGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:L
Other - Last Name:KOWALSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:995 E HIGHWAY 33
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-5076
Mailing Address - Country:US
Mailing Address - Phone:402-826-6689
Mailing Address - Fax:402-826-4101
Practice Address - Street 1:995 E HIGHWAY 33
Practice Address - Street 2:SUITE 1
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-5076
Practice Address - Country:US
Practice Address - Phone:402-826-6689
Practice Address - Fax:402-826-4101
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE42328163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse