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Individual

ANNIE LONGENECKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5151 PFEIFFER RD STE 350, BLUE ASH, OH 45242-4854
(833) 358-2036
Mailing address
1700 LYONS RD, SUITE A, DAYTON, OH 45458-1882
(937) 438-9100

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
COA.18459-NP
OH

Other

Enumeration date
12/02/2015
Last updated
12/02/2019
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