| Doctor Name: | MRS. INGRID RENE LONG |
| NPI Number: | 1447471909 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED NURSE |
| License Number: | RN0000105970 |
| Business Practice Address: | 295 Scissomtown Rd Whitwell, TN - 373976601 |
| Business Phone Number: | 4236589975 |
| Business Fax Number: | |
| Mailing Address: | 295 Scissomtown Rd, WHITWELL |
| State: | TN |
| Postal Code: | 373976601 |
| Phone Number: | 4236589975 |
| Fax Number: | |
| NPI Enumeration Date: | 05/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | RN0000105970 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |