Provider Demographics
NPI:1841424991
Name:LANGE, MICHELE LYNNE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LYNNE
Last Name:LANGE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:TUTTLE
Mailing Address - State:OK
Mailing Address - Zip Code:73089-8497
Mailing Address - Country:US
Mailing Address - Phone:405-613-4634
Mailing Address - Fax:
Practice Address - Street 1:904 GRANDVIEW RD
Practice Address - Street 2:
Practice Address - City:TUTTLE
Practice Address - State:OK
Practice Address - Zip Code:73089-8497
Practice Address - Country:US
Practice Address - Phone:405-689-0433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK08149668363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily