Provider Demographics
NPI:1609673904
Name:LANGE, MONICA ELIZABETH
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:ELIZABETH
Last Name:LANGE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 W 2ND ST STE LL200
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-5420
Mailing Address - Country:US
Mailing Address - Phone:308-382-1884
Mailing Address - Fax:
Practice Address - Street 1:2309 27TH ST
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:NE
Practice Address - Zip Code:68826-2700
Practice Address - Country:US
Practice Address - Phone:308-380-4078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22287164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse