Individual
STEPHANIE LONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 BOWMAN DR STE E355B, VOORHEES, NJ 08043-9623
(856) 247-7260
(856) 247-7261
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26N011126000
NJ
163WW0000X
Wound Care Registered Nurse
26NJ00069300
NJ
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00069300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099139
—
NJ
Enumeration date
04/10/2007
Last updated
08/20/2024
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