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General NPI Number Information
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NPI Number | 1639310808
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Entity Type | Individual
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Provider Name | TANYA LONG R.N.
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Gender | Female
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Dates
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Enumeration Date | 03/17/2009
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Last Update Date | 03/17/2009
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Provider Practice Location Address
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Address Line | 1 RIVERSIDE CIR
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City | HAYESVILLE
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State | NC
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Zip | 28904-7946
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Country | US
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Telephone | 828-389-8052
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Fax | 828-389-8533
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Provider Business Mailing Address
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Address Line | 870 HOT HOUSE RD
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City | HAYESVILLE
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State | NC
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Zip | 28904-5131
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Country | US
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Telephone |
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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 | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 096495
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License Number State | NC
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