Lange, Andrew
Lange, Andrew is an individual health care provider with primary practice located at 709 Spring Valley Rd , Burlington WI 53105-7614. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Lange, Andrew can be contacted via phone (262) 767-6020.Contact Information
Primary practice address
709 Spring Valley Rd
Burlington WI 53105-7614
Phone: (262) 767-6020
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 085-002426 | Illinois |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1976 | Wisconsin |
Profile Details
| NPI number | 1194771428 |
|---|---|
| LBN Legal business name | Lange, Andrew |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 26th, 2006 |
| Last updated | Oct 2nd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194771428 | NPPES |
| Wisconsin | MEDICAID | 42892000 |
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