Provider Demographics
NPI:1942633664
Name:LANGAN, THERESA MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:MARIE
Last Name:LANGAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 NASBY CT
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:NE
Mailing Address - Zip Code:69022-3594
Mailing Address - Country:US
Mailing Address - Phone:308-293-3466
Mailing Address - Fax:
Practice Address - Street 1:1301 E H ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3482
Practice Address - Country:US
Practice Address - Phone:308-344-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily