Provider Demographics
NPI:1750979373
Name:LONG, ALLISON LELANIA (DNP, PMHNP-BC, APRN)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LELANIA
Last Name:LONG
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:431 JUPITER LAKES BLVD APT 2121B
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7124
Mailing Address - Country:US
Mailing Address - Phone:561-629-0454
Mailing Address - Fax:561-249-7432
Practice Address - Street 1:4600 MILITARY TRL STE 103
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4811
Practice Address - Country:US
Practice Address - Phone:561-855-4846
Practice Address - Fax:561-249-7432
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN1101984363LP0808X, 364SP0808X
FLAPRN11010984363LP0808X
FL11010984363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health