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Individual

MRS. ALIESHA RENAE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2200 ELMWOOD AVE STE D11, LAFAYETTE, IN 47904-2391
(765) 756-5077
Mailing address
6241 N COUNTY ROAD 700 W, MULBERRY, IN 46058-9471
(800) 810-3955

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28262675A
IN

Other

Enumeration date
03/03/2025
Last updated
04/03/2025
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