Provider Demographics
NPI:1992702617
Name:LANGFORD, MARY CHOISSER (ACNP)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:CHOISSER
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:ACNP
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Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:4E
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-7405
Mailing Address - Fax:301-388-1740
Practice Address - Street 1:12011 LEE JACKSON HWY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-3310
Practice Address - Country:US
Practice Address - Phone:703-383-5495
Practice Address - Fax:703-383-5489
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2012-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024132613363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
009860M92Medicare PIN
VAP64107Medicare UPIN