Individual
WANDA H LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
102 N MAGDALEN ST, SAN ANGELO, TX 76903-5400
(325) 658-1511
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
224797
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0342931-05
CERTIFICATION
TX
Enumeration date
03/09/2007
Last updated
03/11/2015
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