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Individual

MS. JOANNA ELIZABETH LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
F.N.P

Contact information

Practice address
1995 BETHABARA RD, WINSTON SALEM, NC 27106-3375
(336) 759-7596
(336) 759-3652
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 759-7596
(336) 759-3652

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5005769
NC
363LF0000X
Family Nurse Practitioner
5005769
NC

Other

Enumeration date
08/27/2012
Last updated
10/28/2020
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