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Individual

BETSY K LONGNECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 741-1515
Mailing address
6063 NORTH ROUND BARN ROAD, RICHMOND, IN 47374-1157
(765) 939-0931

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71000384A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000976667
ANTHEM
IN
01
000001050321
ANTHEM BCBS
IN
05
200450860
IN
05
2445894
OH
Enumeration date
08/02/2005
Last updated
04/04/2017
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