Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | APRN11015817 | FL |
NPI | 1003578931 |
---|---|
Provider Name | Sarah Elizabeth Long |
First Address | Fort Myers, FL 33908-9204 |
Second Address | Fort Myers, FL 33908-9204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2021 |
Last Update Date | 08/10/2021 |