| NPI | 1154920593 |
|---|---|
| Former Name | CANDI NICOLE LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX APRN-CNP835170) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NV RN98099) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 848646) | |
| Enumeration Date | 2020-10-17 |
| Last Update Date | 2023-08-25 |