(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003456609
Provider Name: WANDA K. LONG ACNP-BC
Entity Type: Individual
Taxonomy Code: 363LA2100X
Specialty: Nurse Practitioner
License Number: 95013493
Most Important Dates
Enumeration Date: 01/10/2020
Last Updated: 01/10/2020
Provider Practice Location
40891 BREEZY PASS RD
PALM DESERT
CA
922117263
Practice Location Phone/Fax
Phone: 7577140916
Fax:
Provider Mailing Location
40891 BREEZY PASS RD
PALM DESERT
CA
922117263
Provider Mailing Phone/Fax
Phone: 7577140916
Fax: