Individual
SHERRIE R LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1030 RIVER OAKS DR, JACKSON, MS 39232-9553
(800) 893-9698
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R804367
MS
363L00000X
Nurse Practitioner
Primary
804367
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124253
—
MS
Enumeration date
11/13/2006
Last updated
12/09/2019
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