Individual
BROOKE RENEE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP, RN
Contact information
Practice address
2820 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-5474
(605) 342-3280
Mailing address
2820 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-5474
(605) 342-3280
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R042964
SD
363LF0000X
Family Nurse Practitioner
5930
MN
363LF0000X
Family Nurse Practitioner
Primary
CP001924
SD
Other
Enumeration date
03/22/2018
Last updated
01/22/2021
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