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Individual

KIMBERLY LONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1811 W 2ND ST STE LL200, GRAND ISLAND, NE 68803-5420
(308) 833-3981
Mailing address
4225 N CONSTITUTION AVE, KENESAW, NE 68956-1652
(308) 920-0542

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
17906
NE

Other

Enumeration date
03/20/2025
Last updated
03/20/2025
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