Individual
JULIE RENEE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
599 PEARSON DR, GENOA, IL 60135-1383
(815) 784-6437
(815) 784-3933
Mailing address
599 PEARSON DR, GENOA, IL 60135-1383
(815) 784-6437
(815) 784-3933
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021324
IL
363LF0000X
Family Nurse Practitioner
209021324
IL
Other
Enumeration date
09/18/2020
Last updated
08/03/2021
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