Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 0024176011 | VA |
NPI | 1861998981 |
---|---|
Provider Name | Kathryn Jane Langan |
First Address | Portsmouth, VA 23704-4818 |
Second Address | Portsmouth, VA 23704-4818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2018 |
Last Update Date | 05/04/2018 |