Provider Demographics
NPI:1457510612
Name:LANGMADE, CYNTHIA (PA-C, NP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:LANGMADE
Suffix:
Gender:F
Credentials:PA-C, NP
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 2088
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-2088
Mailing Address - Country:US
Mailing Address - Phone:907-224-3409
Mailing Address - Fax:907-224-5870
Practice Address - Street 1:201 3RD AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664-2088
Practice Address - Country:US
Practice Address - Phone:907-224-3409
Practice Address - Fax:907-224-5870
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12323363L00000X
AK943363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner