NPI | 1225685191 |
---|---|
Former Name | DEBORAH JEAN LONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH 024930) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH APRN.CNP.024930) |
Enumeration Date | 2019-08-24 |
Last Update Date | 2022-05-19 |