Individual
KIMBERLEY LEE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1817 W MORRIS BLVD, MORRISTOWN, TN 37813-2837
(423) 581-3904
(423) 581-3904
Mailing address
1817 W MORRIS BLVD, MORRISTOWN, TN 37813-2837
(423) 581-3904
(423) 581-6120
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
8349
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5440627
—
TN
Enumeration date
07/12/2006
Last updated
11/17/2017
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