Provider Demographics
NPI:1689480600
Name:LANG, SHERRI L-L
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:L-L
Last Name:LANG
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:BOYNTON
Mailing Address - State:OK
Mailing Address - Zip Code:74422-0112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 112
Practice Address - Street 2:
Practice Address - City:BOYNTON
Practice Address - State:OK
Practice Address - Zip Code:74422-0112
Practice Address - Country:US
Practice Address - Phone:918-859-6107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator