Individual
JORDAN LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
9330 PARK WEST BLVD STE 302, KNOXVILLE, TN 37923-4311
(865) 373-7975
(865) 374-2145
Mailing address
2213 GRIFFITTS MILL CIR, MARYVILLE, TN 37803-2568
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
32242
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q077723
—
TN
Enumeration date
08/11/2022
Last updated
10/14/2022
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