Individual
MS. RUTHIE ANITA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
64629 HIGHWAY 41, PEARL RIVER, LA 70452-3611
(985) 863-7100
(985) 863-0085
Mailing address
64629 HIGHWAY 41, PEARL RIVER, LA 70452-3611
(985) 863-7100
(985) 863-0085
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN102300 APO6121
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05922233
—
MS
05
—
2145720
—
LA
Enumeration date
12/08/2010
Last updated
06/18/2015
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