Individual
DR. SHANNON NICOLE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
4288 HUSTONVILLE RD, DANVILLE, KY 40422-9582
(606) 669-9033
Mailing address
4288 HUSTONVILLE RD, DANVILLE, KY 40422-9582
(606) 669-9033
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
CPM23060256
—
367A00000X
Advanced Practice Midwife
Primary
4008146
KY
367A00000X
Advanced Practice Midwife
Primary
CNM10797
KY
Other
Enumeration date
07/06/2023
Last updated
04/06/2026
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