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1831113026
KATHLEEN A LONG
MISHAWAKA, IN
NPI
1831113026
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IN 71001562A)
Enumeration Date
2006-07-27
Last Update Date
2019-01-17
Business Address
KATHLEEN A LONG APRN-BC, ND
420 W 4TH ST
MISHAWAKA, IN 46544-1948
Phone number: 574-307-7673
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Mailing Address
KATHLEEN A LONG APRN-BC, ND
420 W 4TH ST
MISHAWAKA, IN 46544-1948
Phone number: 574-307-7673
Copy
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