Individual
BRENNA JEAN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2009 HOLTON RD, MUSKEGON, MI 49445-1578
(231) 291-8399
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704282784
MI
Other
Enumeration date
08/17/2020
Last updated
12/02/2024
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