Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 12486 | NV |
NPI | 1033233085 |
---|---|
Provider Name | Dr. Elena Langdon |
First Address | Las Vegas, NV 89193-6897 |
Second Address | Henderson, NV 89052-5029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 03/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1144241670 | (05) | NV |
BL8803454 | DEA CERTIFICATE (01) | NV |
LL1432 | MEDICAL LICENSE (01) | NV |