Provider Demographics
NPI:1861175069
Name:LANGAN, KARISSA (CPM)
Entity type:Individual
Prefix:
First Name:KARISSA
Middle Name:
Last Name:LANGAN
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4163
Mailing Address - Street 2:
Mailing Address - City:SELTZER
Mailing Address - State:PA
Mailing Address - Zip Code:17974-0163
Mailing Address - Country:US
Mailing Address - Phone:484-795-6570
Mailing Address - Fax:
Practice Address - Street 1:114 MAIN ST
Practice Address - Street 2:
Practice Address - City:SELTZER
Practice Address - State:PA
Practice Address - Zip Code:17974
Practice Address - Country:US
Practice Address - Phone:484-795-6570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife