Provider Demographics
NPI:1407130784
Name:LANG, NICOLE MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:LANG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:880 CENTRAL ST STE K
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03235-2040
Mailing Address - Country:US
Mailing Address - Phone:603-224-3388
Mailing Address - Fax:603-227-7536
Practice Address - Street 1:880 CENTRAL ST STE K
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-2040
Practice Address - Country:US
Practice Address - Phone:603-224-3388
Practice Address - Fax:603-227-7536
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170910363LF0000X
MARN2310958363LF0000X
NH077550-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily