Provider Demographics
NPI:1639570708
Name:LANG, AMBER R (NP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:R
Last Name:LANG
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:11109 PARKVIEW PLAZA DR # 117
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2345 W FRANKLIN ST
Practice Address - Street 2:EVANSVILLE
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-5100
Practice Address - Country:US
Practice Address - Phone:812-401-0500
Practice Address - Fax:812-402-1271
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2022-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71005114A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner