Kristi Lang

Individual provider Active NPI Registered Nurse · Big Bend, WI

NPI 1083962906 · NPPES record last updated Aug 27, 2012

Key facts

NPI
1083962906
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
152620-30 (WI)
Practice address
W228S9140 Putnam St
Big Bend, WI 53103-9414
Phone
(262) 662-2695
NPI assigned
Aug 27, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
152620-30WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 152620-30 WI Yes

Addresses

Primary practice location

W228S9140 Putnam St
Big Bend, WI 53103-9414

Mailing address

W228S9140 Putnam St
Big Bend, WI 53103-9414

Other providers in Big Bend, WI

All providers in Big Bend, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.