Provider Demographics
NPI:1902279664
Name:LANGSTON, MONICA RAE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:RAE
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4094 HARMANS WAY
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17329-9225
Mailing Address - Country:US
Mailing Address - Phone:717-600-5537
Mailing Address - Fax:
Practice Address - Street 1:400 PINE GROVE CMNS
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5161
Practice Address - Country:US
Practice Address - Phone:717-755-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015581363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA458181FLTMedicare PIN