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Individual

JORDAN LANDON LANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AGACNP-BC

Contact information

Practice address
100 S 4TH ST STE 550, SAINT LOUIS, MO 63102-1897
(866) 849-0692
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673
(417) 730-6430
(417) 269-7567

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2024008286
MO
363LA2100X
Acute Care Nurse Practitioner
235430
AR
363LA2100X
Acute Care Nurse Practitioner
3-002934
AL
363LA2100X
Acute Care Nurse Practitioner
APRN-5820-0
HI
363LA2100X
Acute Care Nurse Practitioner
H190105
IA

Other

Enumeration date
03/04/2024
Last updated
04/17/2026
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