Individual
DANIEL LONGINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2400 HOSPITAL DR STE 130, BOSSIER CITY, LA 71111-2386
(318) 212-7990
(318) 212-7995
Mailing address
1202 LOUISIANA AVE, SHREVEPORT, LA 71101-3910
(318) 212-8951
(318) 212-6752
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
AP08930
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2432117
—
LA
Enumeration date
10/03/2016
Last updated
07/08/2021
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