Individual
ELLEN ADELE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3828 LONGVIEW AVE, ERIE, PA 16510-3530
(814) 528-7046
Mailing address
3828 LONGVIEW AVE, ERIE, PA 16510-3530
(814) 528-7046
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
PN277282
PA
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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