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Individual

JAN P LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN ANP-C

Contact information

Practice address
545 BECKETT RD, SUITE 106, LOGAN TOWNSHIP, NJ 08085-1547
(856) 467-2556
(856) 467-3816
Mailing address
545 BECKETT RD, SUITE 106, LOGAN TOWNSHIP, NJ 08085-1547
(856) 467-2556
(856) 467-3816

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
26NN10757100
NJ
363LP2300X
Primary Care Nurse Practitioner
Primary
26NN10757100
NJ

Other

Enumeration date
11/16/2006
Last updated
07/29/2009
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