Individual
CHARLOTTE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3200 W EULESS BLVD, EULESS, TX 76040-6253
(817) 702-1100
(817) 702-6493
Mailing address
36065 SANTA FE AVE, FORT HOOD, TX 76544-5060
(254) 553-9048
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP130153
TX
Other
Enumeration date
01/29/2016
Last updated
04/18/2023
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