Individual
LACEY ANN LANGERAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1300 ANNE ST NW, BEMIDJI, MN 56601-5103
(218) 751-9746
Mailing address
1300 ANNE ST NW, BEMIDJI, MN 56601-5103
(218) 751-9746
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11187
MN
363AS0400X
Surgical Physician Assistant
Primary
11187
MN
Other
Enumeration date
10/27/2005
Last updated
09/10/2019
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