| Doctor Name: | ANDREW LONG |
| NPI Number: | 1033587860 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN |
| License Number: | 2015032213 |
| Business Practice Address: | 609 W Maple Ave Springdale, AR - 727645335 |
| Business Phone Number: | 4797515711 |
| Business Fax Number: | |
| Mailing Address: | 609 W Maple Ave, SPRINGDALE |
| State: | AR |
| Postal Code: | 727645335 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/10/2015 |
| NPI Last Update Date: | 11/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2015032213 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |