Doctor Name: | MRS. JENNIFER A LONG |
NPI Number: | 1164515169 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N.C.,W.H.N.P. |
License Number: | RN071817 AP04141 |
Business Practice Address: | 431 Homer Rd Minden, LA - 710552933 |
Business Phone Number: | 3183778855 |
Business Fax Number: | 3183778804 |
Mailing Address: | 148 Woodard Dr, MINDEN |
State: | LA |
Postal Code: | 710559025 |
Phone Number: | 3183775785 |
Fax Number: | |
NPI Enumeration Date: | 10/02/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0001X |
License Number: | RN071817 AP04141 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Obstetrics & Gynecology |
Taxonomy Definition: |