Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jordan Landon Lange, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1881451235

Jordan Landon Lange, AGACNP-BC is a Nurse Practitioner in Saint Louis, Missouri. Qualified in 2024, 2 years ago. Works from 2 locations. Licensed in Alabama, Arkansas, Hawaii and Iowa and 2 more.

Years since qualifying
2
Licensed in
AL, AR, HI, IA, IN, MO
In the registry since
2024
Specialties on file
6
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

100 S 4th St Ste 550
Saint Louis, MO 63102-1897
Phone: (866) 849-0692
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3800 S National Ave Ste 600, Springfield, MO 65807-5249 — (000) 000-0000

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 2024008286 (MO)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 235430 (AR)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 3-002934 (AL)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence 71018111A (IN)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence H190105 (IA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence APRN-5820-0 (HI)

Record details

NPI number1881451235
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedMarch 4, 2024
Last updated in NPPESJune 25, 2026
Certification dateJune 25, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Saint Louis