Individual
MARY BRONWYN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS, ACHPN
Contact information
Practice address
1400 JACKSON ST, DENVER, CO 80206-2761
(303) 388-4461
(303) 270-2206
Mailing address
1400 JACKSON ST, DENVER, CO 80206-2761
(303) 388-4461
(303) 398-1211
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R1827185
MN
364SA2200X
Adult Health Clinical Nurse Specialist
173629
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65976754
—
CO
Enumeration date
03/21/2008
Last updated
11/12/2020
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