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Individual
MS. LONA MARIE LONGBRAKE
Active
Individual
MS. LONA MARIE LONGBRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R033717
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5549010
—
SD
Enumeration date
11/17/2010
Last updated
11/17/2010
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