| Doctor Name: | DR. VICKIE D LONG |
| NPI Number: | 1063649200 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DNP,APN,FNP-BC,PMHNP |
| License Number: | 14184 |
| Business Practice Address: | 1669 Stable Run Dr Cordova, TN - 380167624 |
| Business Phone Number: | 9017530494 |
| Business Fax Number: | |
| Mailing Address: | Po Box 4355, CORDOVA |
| State: | TN |
| Postal Code: | 380884355 |
| Phone Number: | 9017530494 |
| Fax Number: | |
| NPI Enumeration Date: | 06/15/2009 |
| NPI Last Update Date: | 09/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 14184 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |