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JENNIFER LEEANN LONG APN

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1013223130

Individual Registrant:
 JENNIFER LEEANN LONG APN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1009 HIGHWAY 18  LAKE CITY, AR 72437-9622 US
Tel: 870-237-9928  Fax: 870-237-1012

Contact information for business:
117 S 2ND ST PO BOX 497 AUGUSTA, AR 72006-2309 US
Tel: 870-347-2534  Fax: 870-347-3492

Registration Information:
NPI: 1013223130
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
ARATP-000303

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
155123749AR05
185303758AR05




HEALTH CARE JOBS AR - Page 1



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