Provider Demographics
NPI:1093495459
Name:LANGFORD, CASEY RAY (APRN)
Entity type:Individual
Prefix:MR
First Name:CASEY
Middle Name:RAY
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:APRN
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Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:239-458-3338
Mailing Address - Fax:239-458-0666
Practice Address - Street 1:126 DEL PRADO BLVD N STE 104
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33909-2713
Practice Address - Country:US
Practice Address - Phone:239-573-1606
Practice Address - Fax:239-573-1044
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2024-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL11027632363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily