Individual
ALLAN LOUIS LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1060 GAFFNEY RD STOP 7400, FORT WAINWRIGHT, AK 99703-5007
(907) 361-5532
Mailing address
2505 ALLEN ADALE RD, FAIRBANKS, AK 99709-2581
(301) 300-2077
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
116420
AK
367500000X
Certified Registered Nurse Anesthetist
Primary
RN521826L
PA
Other
Enumeration date
05/12/2006
Last updated
07/21/2022
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