Individual
LISA N LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8426
(606) 523-8770
(865) 482-4400
Mailing address
800 OAK RIDGE TPKE STE C100, OAK RIDGE, TN 37830-6927
(865) 483-2288
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN158278
TN
363L00000X
Nurse Practitioner
6401P
KY
363LF0000X
Family Nurse Practitioner
Primary
3006401
KY
363LF0000X
Family Nurse Practitioner
APN14799
TN
Other
Enumeration date
03/16/2007
Last updated
05/17/2023
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