Provider Demographics
NPI:1184811820
Name:LANGBEIN, RENEE ANN (IDC)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:ANN
Last Name:LANGBEIN
Suffix:
Gender:F
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS JOHN C. STENNIS CVN 74
Mailing Address - Street 2:MEDICAL DEPARTMENT BOX 67
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96615-2874
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USS JOHN C. STENNIS CVN 74
Practice Address - Street 2:MEDICAL DEPARTMENT BOX 67
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96615-2874
Practice Address - Country:US
Practice Address - Phone:1360-627-2562
Practice Address - Fax:1360-627-2562
Is Sole Proprietor?:No
Enumeration Date:2007-09-26
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman