Jessica Beth Long, AGNP-C

NPI #1194244707 in Eagle, Idaho

Provider Information

NPI Number
1194244707
Entity Type
Individual
Name
Jessica Beth Long, AGNP-C
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Nurse Practitioner
Credential
AGNP-C
Enumeration Date
Sep 14, 2017
Last Updated
Jul 21, 2022

Practice Location

Address
420 E STATE ST STE 135
City
Eagle
State
Idaho
ZIP Code
83616-4898
Phone
(208) 402-9956

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner

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