Provider Demographics
NPI:1649537093
Name:LANGE, JESSICA NOELLE (MD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:NOELLE
Last Name:LANGE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:979 E 3RD ST STE C-925
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2136
Mailing Address - Country:US
Mailing Address - Phone:423-778-5910
Mailing Address - Fax:423-778-5915
Practice Address - Street 1:979 E 3RD ST STE C-925
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:423-778-5910
Practice Address - Fax:423-778-5915
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2018-08-07
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Provider Licenses
StateLicense IDTaxonomies
TN57261208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology