Individual
BRIAHNNON LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-BC
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3000
Mailing address
64 N SAGINAW ST, PONTIAC, MI 48342-2155
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704272824
MI
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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