1003071101 NPI number — ELIZABETH H LANGHANS P.T.

Table of content: ELIZABETH H LANGHANS P.T. (NPI 1003071101)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003071101 NPI number — ELIZABETH H LANGHANS P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANGHANS
Provider First Name:
ELIZABETH
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003071101
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11240 WAPLES MILL RD 403
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22030-6078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-383-6454
Provider Business Mailing Address Fax Number:
703-810-5494

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2021 CHURCH ST
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
NASHVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37203-2021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-342-0246
Provider Business Practice Location Address Fax Number:
615-342-0213
Provider Enumeration Date:
07/28/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  8073 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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