Individual provider · Type 1 NPI
Paulette Denise Long, CRNP
Pediatric Nurse Practitioner · Baltimore, MD
NPI number
1689674004
Active
Practice location
1501 Division St
Baltimore, MD 21217-3121
Fax (410) 728-4412
Mailing address
6005 Healy Farm Rd
Baltimore, MD 21228-5362
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | R064853 (MD) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1689674004
Paulette Denise Long, CRNP's National Provider Identifier is 1689674004, issued on Jul 28, 2005. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Baltimore, MD. The record was last updated on Dec 22, 2010.