Long, Kelly Patricia

Long, Kelly Patricia is an individual health care provider with primary practice located at 900 E 13Th St Suite 101, Grove OK 74344-2975. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Long, Kelly Patricia can be contacted via phone (918) 786-9900.

Contact Information

Primary practice address
900 E 13Th St Suite 101 Grove OK 74344-2975
Phone: (918) 786-9900
Fax: (918) 786-9904
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 61374 Oklahoma

Profile Details

NPI number 1447551817
LBN Legal business name Long, Kelly Patricia
Credentials APRN, CPNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2010
Last updated Apr 5th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447551817 NPPES
Oklahoma MEDICAID 200311440A
Oklahoma MEDICAID 200505990H

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