Benjamin C Long
Nurse Practitioner in Joplin, MO. Individual provider (NPI-1).
NPI number1982102885
StatusActive
Last updated in NPPESJan 25, 2018
Details
- NPI
- 1982102885
- Entity type
- Individual (NPI-1)
- Name
- Benjamin C Long
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 25, 2018
- Last updated
- Jan 25, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 2018002044 | MO | Yes |
Practice location
3105 McClelland Blvd.Joplin, MO 64804
Phone 417-347-5400 · Fax 417-347-0620
Mailing address
3105 McClelland Blvd.Joplin, MO 64804
Phone 417-347-5400 · Fax 417-347-0620
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