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Individual

DENNIS W LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
224 N FREDERICK ST, CAPE GIRARDEAU, MO 63701-5626
(573) 332-0121
(573) 332-0120
Mailing address
PO BOX 1933, CAPE GIRARDEAU, MO 63702-1933
(573) 332-7992
(573) 332-7998

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
096892
MO

Other

Enumeration date
03/26/2007
Last updated
03/19/2013
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