Provider Demographics
NPI:1760616312
Name:LANGE, SARA
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:LANGE
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 1:9301 W 74TH ST STE 130
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2207
Mailing Address - Country:US
Mailing Address - Phone:913-632-9130
Mailing Address - Fax:913-632-9149
Practice Address - Street 1:9301 W 74TH ST STE 130
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2207
Practice Address - Country:US
Practice Address - Phone:913-632-9130
Practice Address - Fax:913-632-9149
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013026066207V00000X
KS04-41086207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology