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General NPI Number Information
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NPI Number | 1396906533
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Entity Type | Individual
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Provider Name | NANCY SUE LONGFORS MD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 2075 GLENN MITCHELL DR STE 512
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-0179
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Country | US
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Telephone | 757-507-8850
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Fax |
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Provider Business Mailing Address
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Address Line | 2075 GLENN MITCHELL DR STE 512
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-0179
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Country | US
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Telephone | 757-507-8850
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 58621
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 65696-20
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | PT17488
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License Number State | ND
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 17488
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License Number State | ND
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101254169
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License Number State | VA
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