Basic Information
Provider Information
NPI: 1033883301
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LANGERMAN
FirstName: RACHAEL
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: MSN, APRN, PMHNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BRIDWELL
OtherFirstName: RACHAEL
OtherMiddleName: E
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MSN, APRN, PMHNP-BC
OtherLastNameType: 1
Mailing Information
Address1: 4020 FOLKER ST
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 995085321
CountryCode: US
TelephoneNumber: 9075631000
FaxNumber: 9075611416
Practice Location
Address1: 2600 DENALI ST STE 300
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 995032746
CountryCode: US
TelephoneNumber: 9073189050
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/02/2021
LastUpdateDate: 10/18/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/17/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X23726AKN Nursing Service ProvidersRegistered Nurse 
363LP0808X182868AKY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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