Provider Demographics
NPI:1407440829
Name:LANGLEY, KATHRINE STEELE (CRNP)
Entity Type:Individual
Prefix:
First Name:KATHRINE
Middle Name:STEELE
Last Name:LANGLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1720
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-1229
Mailing Address - Country:US
Mailing Address - Phone:334-222-1366
Mailing Address - Fax:334-222-1180
Practice Address - Street 1:301 MEDICAL AVE STE A
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-1103
Practice Address - Country:US
Practice Address - Phone:334-222-1355
Practice Address - Fax:334-222-1150
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-136620363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-136620OtherALABAMA BOARD OF NURSING