Individual
MRS. TERRI LEIGH LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
301 S J T STITES ST, SALLISAW, OK 74955-9302
(918) 774-1412
Mailing address
301 S J T STITES ST, SALLISAW, OK 74955-9302
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
55831
OK
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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