Provider Demographics
NPI:1134370026
Name:LANGEL, DOROTHY JEAN (APN)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:JEAN
Last Name:LANGEL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:DOROTHY
Other - Middle Name:JEAN
Other - Last Name:LANGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:2000 PORT RD
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71601-4610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 W 42ND AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7006
Practice Address - Country:US
Practice Address - Phone:870-534-9631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily