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Individual

MARIAH J LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1074
Mailing address
1320 MERCY DR NW, CANTON, OH 44708-2614
(330) 489-1000

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN.CNP.0027706
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1477141430
ACUTE CARE
Enumeration date
01/05/2021
Last updated
02/23/2021
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