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Individual
TABITHA LONG
Active
Individual
TABITHA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
264775
MT
363LF0000X
Family Nurse Practitioner
Primary
904368
MS
363LF0000X
Family Nurse Practitioner
Primary
904396
MS
Other
Enumeration date
01/25/2021
Last updated
01/12/2026
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