Provider Demographics
NPI:1457738882
Name:LANGUB, KIMBERLY ANN (APRN/MASTER OF SCIEN)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:LANGUB
Suffix:
Gender:F
Credentials:APRN/MASTER OF SCIEN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 TUCKER DR
Mailing Address - Street 2:
Mailing Address - City:MAYSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41056-9182
Mailing Address - Country:US
Mailing Address - Phone:606-759-9921
Mailing Address - Fax:606-759-9831
Practice Address - Street 1:2010 CUMBERLAND AVENUE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965
Practice Address - Country:US
Practice Address - Phone:606-242-2077
Practice Address - Fax:606-242-2027
Is Sole Proprietor?:No
Enumeration Date:2015-05-06
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily