Individual
DANIELLE ELAINE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24276 166TH ST AIRPORT ROAD, BOX 1012, EAGLE BUTTE, SD 57625-1012
(605) 964-7724
Mailing address
PO BOX 1012, EAGLE BUTTE, SD 57625-1012
(605) 964-7724
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R044583
SD
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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