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Contact Information

SUPATTRA LANGE
2101 ELM ST N
FARGO, ND58102-2417
 Phone: 701-239-3767
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical-Surgical

163WM0705X
Indicates primary specialty

NPI Profile & details for SUPATTRA LANGE · (Female)

NPI # 1316756125
Status Active
Credentials
Entity Individual
Enumeration date 01/06/2025
Last updated 01/06/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • ND License # R42469
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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