Provider Demographics
NPI:1003364795
Name:LANG, JENNIFER JONES (NP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JONES
Last Name:LANG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SANGAMORE RD
Mailing Address - Street 2:S207
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2508
Mailing Address - Country:US
Mailing Address - Phone:202-684-7167
Mailing Address - Fax:
Practice Address - Street 1:5550 FRIENDSHIP BLVD STE T90
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-7313
Practice Address - Country:US
Practice Address - Phone:240-737-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR219914363LA2200X, 363LF0000X
DCRN1025415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health