Individual
BRANDY MICHELLE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1736 E MAIN ST, DOTHAN, AL 36301-3040
(334) 712-9999
(334) 702-2119
Mailing address
PO BOX 678402, DALLAS, TX 75267-8402
(334) 712-9999
(334) 702-2119
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-104421
AL
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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