| NPI | 1932413747 |
|---|---|
| Former Name | TERRESA A LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 84565) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5004840) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2023-11-21 |