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Individual

JENNIFER V LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
12500 WILLOWBROOK RD, CUMBERLAND, MD 21502
(240) 964-3200
Mailing address
PO BOX 1571, SUITE 307, CUMBERLAND, MD 21501-1571
(301) 723-4965
(301) 723-4983

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
R141065
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
R141065
MD

Other

Enumeration date
05/08/2008
Last updated
08/17/2018
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