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Individual

CAROL A. LANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHCNP

Contact information

Practice address
5201 HARRY HINES BLVD, MEDICAL STAFF SERVICES, DALLAS, TX 75235-7708
(214) 590-8006
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
240909
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
041563002
TX
05
041563003
TX
05
041563004
TX
05
041563005
TX
05
041563006
TX
05
041563007
TX
05
041563008
TX
05
041563009
TX
05
041563010
TX
05
041563011
TX
05
041563012
TX
Enumeration date
12/21/2006
Last updated
04/06/2009
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