Individual
MARIA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN FNP BC
Contact information
Practice address
208 FLETCHER AVE, COUNCIL BLUFFS, IA 51503-3021
(402) 709-6878
Mailing address
208 FLETCHER AVE, COUNCIL BLUFFS, IA 51503-3021
(402) 709-6878
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A112937
IA
Other
Enumeration date
12/20/2015
Last updated
12/28/2015
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