Provider Demographics
NPI:1518714112
Name:LANG, DENISE LOUISE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:LOUISE
Last Name:LANG
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5706 ROAD 60
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-9597
Mailing Address - Country:US
Mailing Address - Phone:509-416-7808
Mailing Address - Fax:509-416-7827
Practice Address - Street 1:5706 ROAD 60
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-9597
Practice Address - Country:US
Practice Address - Phone:509-416-7808
Practice Address - Fax:509-416-7827
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00127326163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health