Provider Demographics
NPI:1932576790
Name:PAULA LANGELOH, APRN, LLC
Entity Type:Organization
Organization Name:PAULA LANGELOH, APRN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANGELOH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:260-609-3576
Mailing Address - Street 1:3256 W CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-9181
Mailing Address - Country:US
Mailing Address - Phone:260-609-3576
Mailing Address - Fax:
Practice Address - Street 1:695 N OPPORTUNITY DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1041
Practice Address - Country:US
Practice Address - Phone:260-609-3576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003989A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty