Provider Demographics
NPI:1992970529
Name:LANGRIDGE, MARYANN
Entity type:Individual
Prefix:MRS
First Name:MARYANN
Middle Name:
Last Name:LANGRIDGE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MARYANN
Other - Middle Name:
Other - Last Name:LANGRIDGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN MSN/MBA
Mailing Address - Street 1:11856 WESTMINSTER CT
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4175
Mailing Address - Country:US
Mailing Address - Phone:909-799-2024
Mailing Address - Fax:
Practice Address - Street 1:11856 WESTMINSTER COURT
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354
Practice Address - Country:US
Practice Address - Phone:909-799-2024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA513721163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse