Individual provider · Type 1 NPI

Mary Patricia Lange, PhD, NP

Primary Care Nurse Practitioner · Detroit, MI

NPI number 1740394055 Active

Practice location

4601 John R
Detroit, MI 48201

Call (313) 576-3955 Map

Fax (313) 576-1191

Mailing address

29344 Glencastle Dr
Farmington Hills, MI 48336-1418

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X4704103457 (MI)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1740394055

Mary Patricia Lange, PhD, NP's National Provider Identifier is 1740394055, issued on Aug 17, 2006. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Detroit, MI. The record was last updated on Jul 8, 2007.