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Individual

ALYSON LANG LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
300 SAINT ELIZABETH WAY STE 110, ST JOHNS, FL 32259-1153
(904) 691-9100
(904) 691-9129
Mailing address
300 SAINT ELIZABETH WAY STE 110, ST JOHNS, FL 32259-1153
(904) 691-9100
(904) 691-9129

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP3046612
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
45681
MEDICARE - GROUP
FL
01
E8940W
MEDICARE - INDIVIDUAL
FL
01
Y0F0J
FLORIDA BLUE
FL
Enumeration date
08/07/2006
Last updated
07/07/2026
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