Basic Information
Provider Information
NPI: 1740483304
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LANGER
FirstName: MERRILEE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: R.N.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6549 S 112TH EAST AVE
Address2:  
City: TULSA
State: OK
PostalCode: 741332677
CountryCode: US
TelephoneNumber: 9182490715
FaxNumber:  
Practice Location
Address1: 7010 S YALE AVE STE 215
Address2:  
City: TULSA
State: OK
PostalCode: 741365743
CountryCode: US
TelephoneNumber: 9184922554
FaxNumber: 9184949870
Other Information
ProviderEnumerationDate: 06/08/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808XR0030431OKY Nursing Service ProvidersRegistered NursePsych/Mental Health

No ID Information.


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