Provider Demographics
NPI:1649793555
Name:LANGFORD, MATTHEW NEAL (PMHNP)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:NEAL
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11 BATTLEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-5532
Mailing Address - Country:US
Mailing Address - Phone:931-284-2433
Mailing Address - Fax:931-528-9738
Practice Address - Street 1:1200 S WILLOW AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38506-4157
Practice Address - Country:US
Practice Address - Phone:931-432-4123
Practice Address - Fax:931-432-4123
Is Sole Proprietor?:No
Enumeration Date:2017-07-23
Last Update Date:2017-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000023000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health