Individual
CANDICE LEANN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1500 ROSS CLARK CIR, DOTHAN, AL 36301
(334) 793-2663
Mailing address
1106 N HAVEN CIR, LYNN HAVEN, FL 32444-2934
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP9446218
FL
363LF0000X
Family Nurse Practitioner
Primary
1-133554
AL
Other
Enumeration date
06/13/2018
Last updated
05/02/2022
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