Kerry Long
Specialist in Jackson, MI. Individual provider (NPI-1).
NPI number1114643178
StatusActive
Last updated in NPPESNov 15, 2022
Details
- NPI
- 1114643178
- Entity type
- Individual (NPI-1)
- Name
- Kerry Long
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 12, 2022
- Certification date
- Nov 15, 2022
- Last updated
- Nov 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
| 171000000X | Military Health Care Provider | – | – | |
| 171400000X | Health & Wellness Coach | – | – | |
| 171M00000X | Case Manager/Care Coordinator | – | – | |
| 172V00000X | Community Health Worker | – | – | |
| 225800000X | Recreation Therapist | – | – |
Practice location
1203 1st St Ste 505Jackson, MI 49203-3034
Phone 517-227-3700 · Fax 888-323-2176
Mailing address
1203 1st St Ste 505Jackson, MI 49203-3034
Phone 517-227-3700 · Fax 888-323-2176
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