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Individual

KIMM CHRISTINE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACCNS-AG

Contact information

Practice address
1600 N MORLEY ST STE A120, MOBERLY, MO 65270-3685
(660) 372-9595
(660) 372-9696
Mailing address
1600 N MORLEY ST, MOBERLY, MO 65270-3666
(660) 372-9595

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
153901
MO
364SA2100X
Acute Care Clinical Nurse Specialist
2016022480
MO
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
2016022480
MO
364SG0600X
Gerontology Clinical Nurse Specialist
2016022480
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790137651
MO
Enumeration date
07/04/2016
Last updated
10/17/2018
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