Provider Demographics
NPI:1245529882
Name:LANGMEAD, SHANNON MARY (APN-BC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:MARY
Last Name:LANGMEAD
Suffix:
Gender:F
Credentials:APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:PHIPPS 117
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:410-502-6732
Mailing Address - Fax:410-614-0845
Practice Address - Street 1:601 N CAROLINE ST
Practice Address - Street 2:5TH FLOOR-NEUROLOGY DEPARTMENT
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0006
Practice Address - Country:US
Practice Address - Phone:410-502-6732
Practice Address - Fax:410-614-0845
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR163813363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health