Provider Demographics
NPI:1548742422
Name:LONG, RHONDA LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:LYNN
Last Name:LONG
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 HIGH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-3029
Mailing Address - Country:US
Mailing Address - Phone:570-748-7714
Mailing Address - Fax:570-748-0323
Practice Address - Street 1:529 HIGH ST STE 2
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-3029
Practice Address - Country:US
Practice Address - Phone:570-748-7714
Practice Address - Fax:570-748-0323
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPNO52206L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse