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Individual

DIANE PAIGE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1405 CLIFTON RD NE, ATLANTA, GA 30322-4634
(404) 785-6395
(404) 785-1994
Mailing address
601 5TH ST S, CARDIOLOGY, ST PETERSBURG, FL 33701-4804
(727) 767-4954
(727) 767-2880

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
ARNP 9246874
FL
363LP0200X
Pediatric Nurse Practitioner
F381443
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
RN280201
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02202371
NY
Enumeration date
06/06/2006
Last updated
07/19/2024
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