Provider Demographics
NPI:1558880047
Name:LANG, SUMMER (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:SUMMER
Middle Name:
Last Name:LANG
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16773 W MELVIN ST
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-6119
Mailing Address - Country:US
Mailing Address - Phone:928-242-9659
Mailing Address - Fax:
Practice Address - Street 1:16773 W MELVIN ST
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-6119
Practice Address - Country:US
Practice Address - Phone:928-242-9659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103667163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant