Individual
CARRIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2125 16TH ST, BEDFORD, IN 47421-3003
(812) 275-4053
Mailing address
2125 16TH ST, BEDFORD, IN 47421-3003
(812) 275-4053
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28161644A
IN
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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