Individual
GILLIAN K LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1 PROFESSIONAL DR, ALTON, IL 62002-5068
(618) 463-8500
(618) 433-6792
Mailing address
660 MASON RIDGE CENTER DR STE 300, SAINT LOUIS, MO 63141-8512
(314) 448-3791
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209018721
IL
Other
Enumeration date
06/20/2019
Last updated
09/19/2025
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