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Individual

WILLIAM LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1400 E BOULDER ST STE 500, COLORADO SPRINGS, CO 80909-5533
(719) 364-6487
Mailing address
2472 RAYWOOD VW APT 626, COLORADO SPRINGS, CO 80920-7757
(210) 213-6897

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
C-APN.0003031-C-NP
CO
363LG0600X
Gerontology Nurse Practitioner
C-APN.0003031-C-NP
CO

Other

Enumeration date
11/14/2021
Last updated
11/14/2021
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