| NPI | 1982009288 |
|---|---|
| Former Name | KATIE MARIE LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.16759) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.16759) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2022-12-09 |