Individual
JERI LYNN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8 RICHLAND MEDICAL PARK DR STE 400, COLUMBIA, SC 29203-8004
(803) 765-0871
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3841
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP1442
—
SC
Enumeration date
06/17/2009
Last updated
01/30/2018
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