MEDICARE: MRS. JULIE LYNN LONG N.P.

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	363LW0102X	Women's Health Nurse Practitioner	608462	TX
2	363LW0102X	Women's Health Nurse Practitioner	AP109241	TX

General Provider Information

NPI Number	:	1902009848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE LYNN LONG N.P.

Provider Business Mailing Address
First Line	:	3425 BEE CAVES RD STE B3
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6693
Country	:	US
Telephone Number	:	512-865-4424
Fax Number	:	512-500-2028

Provider Business Practice Location Address
First Line	:	3425 BEE CAVES RD STE B3
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6693
Country	:	US
Telephone Number	:	512-865-4424
Fax Number	:	512-500-2028

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	12/11/2024

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