Individual
ELIZABETH M. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-C
Contact information
Practice address
755 N 11TH ST, SUITE P-5200, BEAUMONT, TX 77702-1500
(409) 898-2994
(409) 983-5146
Mailing address
7945 GLENEAGLES DR, BEAUMONT, TX 77707-5466
(409) 840-4999
(409) 983-5146
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
537565
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183746001
MEDICAID GROUP
TX
05
—
183748601
—
TX
01
—
537565
APRN-C LICENSE #
TX
Enumeration date
06/26/2006
Last updated
02/15/2017
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