Provider Demographics
NPI:1417285446
Name:LANGENDOERFER, ALAN L (RNFA)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:LANGENDOERFER
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19974 E REINS RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-4910
Mailing Address - Country:US
Mailing Address - Phone:480-882-2494
Mailing Address - Fax:480-882-2494
Practice Address - Street 1:19974 E REINS RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-4910
Practice Address - Country:US
Practice Address - Phone:480-882-2494
Practice Address - Fax:480-882-2494
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN138965163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant