Individual
ANGELA DESIREE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC, PMHNP-BC
Contact information
Practice address
11560 CROSSROADS CIR STE 102, MIDDLE RIVER, MD 21220-2885
(410) 508-0722
Mailing address
11560 CROSSROADS CIR STE 102, MIDDLE RIVER, MD 21220-2885
(410) 508-0722
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R192628
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R192628
MD
Other
Enumeration date
10/02/2015
Last updated
06/28/2022
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