Individual
WANDA K. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
40891 BREEZY PASS RD, PALM DESERT, CA 92211-7263
(757) 714-0916
Mailing address
40891 BREEZY PASS RD, PALM DESERT, CA 92211-7263
(757) 714-0916
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95013493
CA
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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