Provider Demographics
NPI:1477547891
Name:NANCY L LONG MD ASSOCIATES FOR WOMENS HEALTH PC
Entity type:Organization
Organization Name:NANCY L LONG MD ASSOCIATES FOR WOMENS HEALTH PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-837-9400
Mailing Address - Street 1:2610 W. HORIZON RIDGE PARKWAY
Mailing Address - Street 2:STE. 105
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2870
Mailing Address - Country:US
Mailing Address - Phone:702-837-9400
Mailing Address - Fax:702-617-9311
Practice Address - Street 1:2610 W. HORIZON RIDGE PARKWAY
Practice Address - Street 2:STE. 105
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2870
Practice Address - Country:US
Practice Address - Phone:702-837-9400
Practice Address - Fax:702-617-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5916363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVE81405Medicare UPIN