Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 204797 | NC |
Y | 363LP2300X | Nurse Practitioner - Primary Care | 204797 | NC |
NPI | 1033361373 |
---|---|
Provider Name | Mrs. Jessica Kaplan Langston |
First Address | Raleigh, NC 27615 |
Second Address | Raleigh, NC 27615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2008 |
Last Update Date | 29/12/2011 |