Lange, Brooke A
Lange, Brooke A is an individual health care provider with primary practice located at 830 W High St Ste 360 , Lima OH 45801-3985. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Lange, Brooke A can be contacted via phone (419) 227-7117.Contact Information
Primary practice address
830 W High St Ste 360
Lima OH 45801-3985
Phone: (419) 227-7117
Fax: (419) 227-2848
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 50.004109 | Ohio |
Profile Details
| NPI number | 1093103038 |
|---|---|
| LBN Legal business name | Lange, Brooke A |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2014 |
| Last updated | Apr 1st, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093103038 | NPPES |
| Ohio | MEDICAID | 0116351 | |
| Ohio | Other | 9943723 | |
| Ohio | Other | 1184652539 | |
| Ohio | Other | 0105065 |
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