Individual
LILLIAN B LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
420 S 7TH ST, OAKES, ND 58474-2024
(701) 742-3267
(701) 742-3201
Mailing address
PO BOX 50, OAKES, ND 58474-0050
(701) 742-3267
(701) 742-3201
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R17515
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699086124
—
MN
05
—
84000
—
ND
01
—
P00852224
RR MEDICARE
ND
Enumeration date
06/30/2010
Last updated
01/20/2014
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