Provider Demographics
NPI:1598932204
Name:LONG, ELISABETH A (ARNP)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:A
Last Name:LONG
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Gender:F
Credentials:ARNP
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Mailing Address - Street 1:1223 S GEAR AVE
Mailing Address - Street 2:STE 208
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-1682
Mailing Address - Country:US
Mailing Address - Phone:319-752-4541
Mailing Address - Fax:319-752-2972
Practice Address - Street 1:1223 S GEAR AVE
Practice Address - Street 2:STE 208
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1682
Practice Address - Country:US
Practice Address - Phone:319-752-4541
Practice Address - Fax:319-752-2972
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2012-11-07
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Provider Licenses
StateLicense IDTaxonomies
IAF066084363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology