Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | R219914 | MD |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | R219914 | MD |
N | 363LF0000X | Nurse Practitioner - Family Medicine | RN1025415 | DC |
NPI | 1003364795 |
---|---|
Provider Name | Jennifer Jones Lang |
First Address | Bethesda, MD 20816-2508 |
Second Address | Chevy Chase, MD 20815-7313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2016 |
Last Update Date | 06/06/2019 |