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General NPI Number Information
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NPI Number | 1437345204
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Entity Type | Individual
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Provider Name | CHRISTINE L. LONG FNP
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Gender | Female
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 6204 BALCONES DR
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City | AUSTIN
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State | TX
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Zip | 78731-4214
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Country | US
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Telephone | 512-427-9400
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Fax | 512-342-2723
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Provider Business Mailing Address
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Address Line | PO BOX 911230
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City | DALLAS
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State | TX
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Zip | 75391-1230
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Country | US
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Telephone | 972-998-8000
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Fax | 972-234-2987
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 835115
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN135873
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP123805
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License Number State | TX
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