Provider Demographics
NPI:1386673820
Name:LANGLAND, PENNY I (MD)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:I
Last Name:LANGLAND
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:651-254-3699
Practice Address - Street 1:2635 UNIVERSITY AVE SUITE 160 - MAIL STOP 36101A
Practice Address - Street 2:HEALTHPARTNERS REGIONS HEALTH CENTER FOR WOMEN
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1271
Practice Address - Country:US
Practice Address - Phone:651-254-3500
Practice Address - Fax:651-254-3699
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2011-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN26271207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN09365LAOtherMNBS #
MN10236OtherNDBS #
MN904882OtherAMERICA'S PPO/ARAZ #
MN111450OtherUCARE #
MN921867000Medicaid
MNMN100014OtherLHS/BANNERHEALTH #
MN0106025OtherMEDICA #
MN16687Medicaid
MNDA9021015703OtherPREFERRED ONE #
MNHP19536OtherHEALTHPARTNERS #
MN16687Medicaid
MN080016581Medicare PIN
MNMN100014OtherLHS/BANNERHEALTH #
MND48746Medicare UPIN