Individual
MR. JASON ALEXANDER LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
43 SOKOKIS TRL, EAST WATERBORO, ME 04030-5400
(207) 247-6742
(207) 247-6114
Mailing address
48 AVON ST, PORTLAND, ME 04101-2364
(646) 369-8785
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
202105402NP-PP
OR
363LF0000X
Family Nurse Practitioner
Primary
CNP211177
ME
Other
Enumeration date
08/09/2021
Last updated
05/14/2024
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