Individual
DR. TERESA DIANE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3901 RAINBOW BLVD, DEPARTMENT OF PSYCHIATRY, KANSAS CITY, KS 66160
(913) 588-6464
(913) 588-6414
Mailing address
3901 RAINBOW BLVD, 4070 DELP MAIL STOP 4017, KANSAS CITY, KS 66160
(913) 522-6464
(913) 588-6414
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-25118
KS
2084P0800X
Psychiatry Physician
04-25118
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20924044
BCBS KC
MO
01
—
626411
FIRSTGUARD
KS
Enumeration date
10/03/2006
Last updated
09/11/2025
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