Individual
ERIC LONGENECKER
Active
Individual
ERIC LONGENECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
844058
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001530
CA
Other
Enumeration date
11/04/2020
Last updated
12/23/2022
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