Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | RN259922 | GA |
NPI | 1053938720 |
---|---|
Provider Name | Veda N Langford |
First Address | Decatur, GA 30034-1637 |
Second Address | Decatur, GA 30034-1637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2020 |
Last Update Date | 07/07/2021 |