Provider Demographics
NPI:1245539733
Name:LANGLOIS, ANNE MARIE
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:LANGLOIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:NASSIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA -C
Mailing Address - Street 1:5885 SUNNYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4203
Mailing Address - Country:US
Mailing Address - Phone:712-266-2760
Mailing Address - Fax:712-266-2719
Practice Address - Street 1:5885 SUNNYBROOK DR
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4203
Practice Address - Country:US
Practice Address - Phone:712-266-2760
Practice Address - Fax:712-266-2719
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002151363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical