| NPI | 1730824939 |
|---|---|
| Former Name | ALLYN ELISE LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 207381) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 207381) |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2024-03-11 |