Provider Demographics
NPI:1346607470
Name:LANGLOIS, STEPHEN (RN)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:LANGLOIS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 BARRIE RD APT 306
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2309
Mailing Address - Country:US
Mailing Address - Phone:480-277-3463
Mailing Address - Fax:
Practice Address - Street 1:6400 BARRIE RD., APT. 306
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:480-277-3463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN192194163W00000X
MN229689-6163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse