Provider Demographics
NPI:1053877878
Name:LANGENKAMP, BRIANNA (PA)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:LANGENKAMP
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2857 CHARLESTOWN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-1998
Mailing Address - Country:US
Mailing Address - Phone:812-944-7500
Mailing Address - Fax:812-944-6424
Practice Address - Street 1:2857 CHARLESTOWN RD STE 100
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-1998
Practice Address - Country:US
Practice Address - Phone:812-944-7500
Practice Address - Fax:812-944-6424
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-17
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-895363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant