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General NPI Number Information
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NPI Number | 1922809623
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Entity Type | Individual
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Provider Name | JENNIFER CHRISTINE LANGE MS, RD/LD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 3300 NW EXPRESSWAY
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4418
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Country | US
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Telephone | 562-477-6371
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Fax |
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Provider Business Mailing Address
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Address Line | 201 NE 1ST ST APT 204
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-4079
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Country | US
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Telephone | 562-477-3671
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1401X
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Taxonomy Name | Pediatric Critical Care Nutrition Registered Dietitian
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License Number | 86296501
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number | 86296501
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86296501
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License Number State |
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