Individual
MYRNA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 330-4689
Mailing address
875 NE STONERIDGE LOOP, PRINEVILLE, OR 97754-9338
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
064022129RN
OR
Other
Enumeration date
06/13/2008
Last updated
06/13/2008
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