Provider Demographics
NPI:1629691944
Name:LANGLEY, SHAUNTE
Entity Type:Individual
Prefix:MRS
First Name:SHAUNTE
Middle Name:
Last Name:LANGLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11425 CRESTLAKE VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-2939
Mailing Address - Country:US
Mailing Address - Phone:757-779-0023
Mailing Address - Fax:
Practice Address - Street 1:11425 CRESTLAKE VILLAGE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-2939
Practice Address - Country:US
Practice Address - Phone:757-779-0023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula