Provider Demographics
NPI:1477703767
Name:LANGMACK, LAURA CHRISTINE (NP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:CHRISTINE
Last Name:LANGMACK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 WORNALL RD
Mailing Address - Street 2:STE 50
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-5943
Mailing Address - Country:US
Mailing Address - Phone:913-451-7849
Mailing Address - Fax:
Practice Address - Street 1:2500 EXECUTIVE DRIVE
Practice Address - Street 2:# 104
Practice Address - City:ST. CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5013
Practice Address - Country:US
Practice Address - Phone:636-447-2509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA0408021363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health