| Doctor Name: | MS. DWAN WILLIAMS LONG |
| NPI Number: | 1184985889 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN, CPNP-PC |
| License Number: | AP06846 |
| Business Practice Address: | 106 Mimosa St Amite, LA - 704222136 |
| Business Phone Number: | 9852472411 |
| Business Fax Number: | 9852472415 |
| Mailing Address: | 106 Mimosa St, AMITE |
| State: | LA |
| Postal Code: | 704222136 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/30/2012 |
| NPI Last Update Date: | 06/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | AP06846 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |