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Individual

BRIAN LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2211 LOMAS BLVD NE, 2ND FLOOR, ALBUQUERQUE, NM 87106-2719
(505) 272-2336
(505) 272-5103
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-1320

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
720372
TX
363LF0000X
Family Nurse Practitioner
Primary
CNP-02380
NM

Other

Enumeration date
09/25/2006
Last updated
03/22/2017
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