Individual
DYLAN MICHAEL LONGNECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNAP, CRNA
Contact information
Practice address
1250 E MARSHALL ST, RICHMOND, VA 23298-5023
(804) 628-4748
Mailing address
9520 COTTESMORE LN, HENRICO, VA 23228-2042
(434) 422-2791
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024180810
VA
Other
Enumeration date
01/20/2021
Last updated
01/21/2021
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