Provider Demographics
NPI:1437139433
Name:LANGFORD, PATSY ANN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:PATSY
Middle Name:ANN
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:PATSY
Other - Middle Name:ANN
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5314 MOUNTAIN PARK CIR
Mailing Address - Street 2:
Mailing Address - City:INDIAN SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:35124-3042
Mailing Address - Country:US
Mailing Address - Phone:205-886-1682
Mailing Address - Fax:205-759-5999
Practice Address - Street 1:995 9TH AVE SW
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-4527
Practice Address - Country:US
Practice Address - Phone:205-481-8729
Practice Address - Fax:205-481-8732
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1056727367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009964760Medicaid
P32229Medicare UPIN
AL051550651Medicare ID - Type Unspecified