Individual
MARYELLEN LANGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP/APRN
Contact information
Practice address
25 N 100 E, SUITE #102, ST GEORGE, UT 84770
(435) 986-2565
(435) 986-2577
Mailing address
25 N 100 E, SUITE #102, ST GEORGE, UT 84770
(435) 986-2565
(435) 986-2577
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10209861-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
SP015440
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103116325-0004
—
PA
Enumeration date
07/08/2015
Last updated
06/16/2018
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