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General NPI Number Information
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NPI Number | 1952111577
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Entity Type | Individual
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Provider Name | CRISTINA MARIE LONG FNP
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Gender | Female
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Dates
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Enumeration Date | 01/08/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 21 E STATE ST
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City | COLUMBUS
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State | OH
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Zip | 43215-4281
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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Provider Business Mailing Address
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Address Line | 730 COLUMBIA ST
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City | NEWPORT
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State | KY
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Zip | 41071-1837
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Country | US
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Telephone | 813-389-6197
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0038023
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4030417
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License Number State | KY
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