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1194244707
JESSICA BETH LONG
EAGLE, ID
NPI
1194244707
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Other Name
JESSICA BETH MITCHELL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: ID 56895)
Enumeration Date
2017-09-14
Last Update Date
2022-07-21
Business Address
JESSICA BETH LONG AGNP-C
420 E STATE ST STE 135
EAGLE, ID 83616-4898
Phone number: 208-402-9956
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Mailing Address
JESSICA BETH LONG AGNP-C
420 E STATE ST STE 135
EAGLE, ID 83616-4898
Phone number: 208-402-9956
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