Individual
JEANNETTE C LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
721 THOMPSON DRIVE, KERRVILLE, TX 78028
(830) 896-2211
Mailing address
721 THOMPSON DRIVE, KERRVILLE, TX 78028
(830) 896-2211
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
689869
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170750701
—
TX
Enumeration date
10/03/2006
Last updated
07/08/2007
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