Individual
MS. YOLANDA PATRICE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3702 JEFFERSON AVE, PASCAGOULA, MS 39563-6218
(228) 205-4592
(228) 205-4593
Mailing address
1240 BROAD AVE STE B, GULFPORT, MS 39501-2416
(544) 414-2072
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R866997
MS
363LF0000X
Family Nurse Practitioner
1-099664
AL
363LP2300X
Primary Care Nurse Practitioner
Primary
905597
MS
Other
Enumeration date
10/30/2014
Last updated
03/14/2024
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