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Individual

DONNA M LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1924 ALCOA HWY, U109, KNOXVILLE, TN 37920-1511
(865) 544-9220
Mailing address
319 ERIN DR, STE B, KNOXVILLE, TN 37919-6202
(865) 588-0880

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN71153
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
041861
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041861
CRNA LICENSE
TN
01
RN71153
RN LICENSE
TN
Enumeration date
02/08/2006
Last updated
05/04/2010
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