Provider Demographics
NPI:1740245810
Name:LANGDON, CAROLYN LOUISE (NNP)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:LOUISE
Last Name:LANGDON
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4323 W LAPENNA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85087-4905
Mailing Address - Country:US
Mailing Address - Phone:623-518-9420
Mailing Address - Fax:623-518-9420
Practice Address - Street 1:901 E WILLETTA ST
Practice Address - Street 2:RM. 3503
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2727
Practice Address - Country:US
Practice Address - Phone:602-239-2635
Practice Address - Fax:602-239-2307
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ17363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care