Individual
PAULETTE DENISE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1501 DIVISION ST, BALTIMORE, MD 21217-3121
(410) 383-8300
(410) 728-4412
Mailing address
6005 HEALY FARM RD, BALTIMORE, MD 21228-5362
(410) 744-2665
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R064853
MD
Other
Enumeration date
07/28/2005
Last updated
12/22/2010
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