Individual
MISS ISHA JUANELLE LANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1000 WALTERS ST, LAKE CHARLES, LA 70607-4647
(337) 480-3209
Mailing address
4345 NELSON RD, LAKE CHARLES, LA 70605-4119
(337) 480-3209
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
363LF0000X
Family Nurse Practitioner
Primary
AP07953
LA
Other
Enumeration date
09/05/2014
Last updated
07/03/2019
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