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Individual
HEATHER LYNN LONGO
Active
Individual
HEATHER LYNN LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
277467
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
277467
LPN LICENSE
NY
Enumeration date
01/11/2013
Last updated
01/11/2013
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