| NPI | 1649558941 |
|---|---|
| Former Name | CARRIE ELIZABETH LANGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3006670) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH 13198-NP) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WV 56570) | |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2020-09-22 |