Individual
NICHOLE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1010 S RIO GRANDE AVE, MONTROSE, CO 81401-4831
(970) 787-2074
Mailing address
PO BOX 1338, NORWOOD, CO 81423-1338
(970) 640-8896
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
190041
CO
Other
Enumeration date
03/10/2022
Last updated
03/10/2022
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