NICOLE DIANE LONG

IDAHO FALLS, ID
NPI1891058939
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: ID  NP-1171A)
Enumeration Date2012-06-22
Last Update Date2012-06-22
Business Address
-- NICOLE DIANE LONG FNP-C
2990 CORTEZ AVE
IDAHO FALLS, ID 83404-7554
Phone number: 208-535-0440
Mailing Address
-- NICOLE DIANE LONG FNP-C
2990 CORTEZ AVE
IDAHO FALLS, ID 83404-7554
Phone number: 208-535-0440
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