Individual provider · Type 1 NPI
Mary Lavonne Long, APRN
Family Nurse Practitioner · Smyrna, GA
NPI number
1295877033
Active
Practice location
3969 S Cobb Dr SE Ste 206
Smyrna, GA 30080-6317
Fax (770) 432-5740
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | RN077139 (GA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1295877033
Mary Lavonne Long, APRN's National Provider Identifier is 1295877033, issued on Feb 12, 2007. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Smyrna, GA. The record was last updated on Jul 8, 2007.