Provider Demographics
NPI:1700626967
Name:LANGFORD, AMY LYNN
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:BOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5544 400TH LN
Mailing Address - Street 2:
Mailing Address - City:HAY SPRINGS
Mailing Address - State:NE
Mailing Address - Zip Code:69347-4105
Mailing Address - Country:US
Mailing Address - Phone:308-539-4410
Mailing Address - Fax:
Practice Address - Street 1:815 FLACK AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-2722
Practice Address - Country:US
Practice Address - Phone:308-225-6572
Practice Address - Fax:308-217-4277
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE115375363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health