Provider Demographics
NPI:1508258641
Name:LANGENBACH, JEAN E (RN, BS)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:E
Last Name:LANGENBACH
Suffix:
Gender:F
Credentials:RN, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 WELSH RD STE 202
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2210
Mailing Address - Country:US
Mailing Address - Phone:215-335-4416
Mailing Address - Fax:215-338-4426
Practice Address - Street 1:2417 WELSH RD STE 202
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2210
Practice Address - Country:US
Practice Address - Phone:215-335-4416
Practice Address - Fax:215-338-4426
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN157326L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse