MEDICARE: TWYNETTE DENISE LONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		DC

General Provider Information

NPI Number	:	1487519005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TWYNETTE DENISE LONG

Provider Business Mailing Address
First Line	:	9709 KEY WEST AVE APT 386
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-4520
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 EASTERN AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-2833
Country	:	US
Telephone Number	:	202-248-2356
Fax Number	:	202-978-6143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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Directions to “ TWYNETTE DENISE LONG ” Practice Location

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