Provider Demographics
NPI:1184164808
Name:LANG, LORIANN ROCHELLE (CPNP)
Entity type:Individual
Prefix:
First Name:LORIANN
Middle Name:ROCHELLE
Last Name:LANG
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:LORIANN
Other - Middle Name:ROCHELLE
Other - Last Name:CAMPOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7529 E WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-1525
Mailing Address - Country:US
Mailing Address - Phone:310-702-1501
Mailing Address - Fax:
Practice Address - Street 1:1450 S DOBSON RD STE B220
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4745
Practice Address - Country:US
Practice Address - Phone:480-827-5044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP9941363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics