Individual
COURTNEY LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 S 5TH AVE, WEST READING, PA 19611-2143
(484) 628-5455
Mailing address
PO BOX 13579, READING, PA 19612-3579
(484) 628-0799
(484) 334-7026
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN578356
PA
363LG0600X
Gerontology Nurse Practitioner
Primary
SP016904
PA
Other
Enumeration date
10/14/2016
Last updated
12/09/2016
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