Individual
JESSICA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1739 E BEVERLY AVE STE 217, KINGMAN, AZ 86409-3593
(928) 681-8724
Mailing address
1739 E BEVERLY AVE STE 217, KINGMAN, AZ 86409-3593
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
309454
AZ
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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