Healthcare Provider Details

I. General information

NPI: 1477547891
Provider Name (Legal Business Name): NANCY L LONG MD ASSOCIATES FOR WOMENS HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 W. HORIZON RIDGE PARKWAY STE. 105
HENDERSON NV
89052-2870
US

IV. Provider business mailing address

2610 W. HORIZON RIDGE PARKWAY STE. 105
HENDERSON NV
89052-2870
US

V. Phone/Fax

Practice location:
  • Phone: 702-837-9400
  • Fax: 702-617-9311
Mailing address:
  • Phone: 702-837-9400
  • Fax: 702-617-9311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number5916
License Number StateNV

VIII. Authorized Official

Name: DR. NANCY L LONG
Title or Position: PRESIDENT
Credential: MD
Phone: 702-837-9400