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Individual
LISA LAVONN LONG
Active
Individual
LISA LAVONN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNS
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
R1414190
MN
Other
Enumeration date
01/17/2008
Last updated
06/27/2018
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