Individual
MRS. LISA MARIE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
604 S WALNUT ST, STILLWATER, OK 74074-4222
(405) 338-7072
Mailing address
604 S WALNUT ST, STILLWATER, OK 74074-4222
(405) 338-7072
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0130734
OK
Other
Enumeration date
12/16/2020
Last updated
07/01/2025
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