Provider Demographics
NPI:1447584719
Name:LANG, SAMANTHA SUE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:SUE
Last Name:LANG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:19401 HUBBARD DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2641
Mailing Address - Country:US
Mailing Address - Phone:313-982-8282
Mailing Address - Fax:313-982-8230
Practice Address - Street 1:19401 HUBBARD DR
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2641
Practice Address - Country:US
Practice Address - Phone:313-982-8282
Practice Address - Fax:313-982-8230
Is Sole Proprietor?:No
Enumeration Date:2009-09-19
Last Update Date:2021-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704126798363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily