Provider Demographics
NPI:1518260587
Name:LONGMIRE-YANCY, PRICILA
Entity Type:Individual
Prefix:
First Name:PRICILA
Middle Name:
Last Name:LONGMIRE-YANCY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3763 WINTER WHITETAIL ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-3616
Mailing Address - Country:US
Mailing Address - Phone:775-287-2395
Mailing Address - Fax:
Practice Address - Street 1:3763 WINTER WHITETAIL ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-3616
Practice Address - Country:US
Practice Address - Phone:775-287-2395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator