Individual
MRS. BRANDY MICHELLE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
421 12TH ST, COLUMBUS, GA 31901-2522
(706) 494-7796
Mailing address
200 WINDSONG DR, CATAULA, GA 31804-2363
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN221302
GA
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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