Provider Demographics
NPI:1629208657
Name:DELANG, DAVID A (NP-C)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:DELANG
Suffix:
Gender:M
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:PO BOX 15399
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-5399
Mailing Address - Country:US
Mailing Address - Phone:850-765-8623
Mailing Address - Fax:850-765-0118
Practice Address - Street 1:1401 OVEN PARK DR STE 201
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7958
Practice Address - Country:US
Practice Address - Phone:850-765-8623
Practice Address - Fax:850-765-0118
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN3017492363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily