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Individual

PATRICIA LYNN LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP, CNS

Contact information

Practice address
368 NORTHEAST AVE, TALLMADGE, OH 44278-1443
(216) 906-4923
Mailing address
368 NORTHEAST AVE, TALLMADGE, OH 44278-1443
(216) 906-4923

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
NP09090
OH
364SG0600X
Gerontology Clinical Nurse Specialist
NS07470
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0078541
OH
Enumeration date
03/27/2007
Last updated
06/03/2015
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