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Individual

MARY LEE LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN,CRNP

Contact information

Practice address
1645 ROSTRAVER RD, BELLE VERNON, PA 15012-9655
(724) 243-0950
(724) 243-0952
Mailing address
1645 ROSTRAVER RD, BELLE VERNON, PA 15012-9655
(724) 243-0950
(724) 243-0952

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP007432
PA

Other

Enumeration date
06/03/2008
Last updated
06/03/2008
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