Provider Demographics
NPI:1285978163
Name:LANGE, LEAH (FNP-C)
Entity type:Individual
Prefix:MS
First Name:LEAH
Middle Name:
Last Name:LANGE
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 S WINTER ST
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:KY
Mailing Address - Zip Code:40347-5002
Mailing Address - Country:US
Mailing Address - Phone:859-846-4445
Mailing Address - Fax:859-846-4761
Practice Address - Street 1:129 S WINTER ST
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:KY
Practice Address - Zip Code:40347-5002
Practice Address - Country:US
Practice Address - Phone:941-539-1362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9216861363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily