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Individual
MRS. HEATHER S LANGE
Active
Individual
MRS. HEATHER S LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28160594A
IN
363L00000X
Nurse Practitioner
Primary
3004811
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000798249
ANTHEM - WS
KY
01
—
143319
SIHO - WS
KY
05
—
200531340
—
IN
01
—
50045366
PASSPORT - WS
KY
05
—
7100224710
—
KY
Enumeration date
06/13/2006
Last updated
05/18/2015
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