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General NPI Number Information
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NPI Number | 1639272974
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Entity Type | Individual
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Provider Name | VALERIE F LONG RN
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Gender | Female
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | DULCE HEALTH CENTER 12000 STONE LAKE ROAD
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City | DULCE
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State | NM
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Zip | 87528-0187
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Country | US
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Telephone | 505-759-3291
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Fax | 505-759-7289
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | DULCE
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State | NM
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Zip | 87528-0187
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Country | US
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Telephone | 505-759-3291
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Fax | 505-759-7289
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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 | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 103762
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 103762
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License Number State | CO
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