Provider Demographics
NPI:1639488539
Name:LANGKAMP, CAROLYN D (WLMT, RN)
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:D
Last Name:LANGKAMP
Suffix:
Gender:F
Credentials:WLMT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 N BARSTOW ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-3790
Mailing Address - Country:US
Mailing Address - Phone:715-225-0461
Mailing Address - Fax:
Practice Address - Street 1:316 N BARSTOW ST
Practice Address - Street 2:SUITE G
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-3790
Practice Address - Country:US
Practice Address - Phone:715-225-0461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3923-146174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist