Individual
KIMBERLY ATHENA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
7238 W HIGHWAY 80, NANCY, KY 42544-8752
(606) 636-4215
(606) 636-4215
Mailing address
31 EVERGREEN DR, SOMERSET, KY 42501-5890
(606) 636-4215
(606) 636-4215
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3009211
KY
363LF0000X
Family Nurse Practitioner
Primary
3009211
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12798047
CAQH
—
05
—
7100341880
—
KY
Enumeration date
02/04/2015
Last updated
08/16/2024
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