Individual
MS. ERICA DENISE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
111 COUNTY ROAD 258, ATHENS, TN 37303-6567
(423) 506-5310
Mailing address
111 COUNTY ROAD 258, ATHENS, TN 37303-6567
(423) 506-5310
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
25975
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77186204
—
TN
Enumeration date
08/16/2019
Last updated
02/09/2022
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