Individual
MARY ELIZABETH LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
11164 MAGGIE LN, MARION, IL 62959-7761
(618) 889-5591
(618) 216-9993
Mailing address
11164 MAGGIE LN, MARION, IL 62959-7761
(618) 889-5591
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.271325
IL
Other
Enumeration date
01/29/2016
Last updated
04/08/2019
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