Individual provider · Type 1 NPI

Kathleen Long, CNP

Pediatric Nurse Practitioner · Plymouth, MI

NPI number 1720129224 Active

Practice location

990 W Ann Arbor Trl, Suite 210
Plymouth, MI 48170-6204

Fax (734) 455-5637

Mailing address

2100 Commonwealth Blvd, Suite 202
Ann Arbor, MI 48105-1593

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X4704148138 (MI)

Pediatric Nurse Practitioner: Definition to come...

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About NPI 1720129224

Kathleen Long, CNP's National Provider Identifier is 1720129224, issued on Feb 9, 2007. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Plymouth, MI. The record was last updated on Jul 8, 2007.