Long, Loretta

Long, Loretta is an individual health care provider with primary practice located at 15 Messimer Dr , Newark OH 43055-1841. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Long, Loretta can be contacted via phone (220) 564-4691.

Contact Information

Primary practice address
15 Messimer Dr Newark OH 43055-1841
Phone: (220) 564-4691
Fax: (220) 564-1975
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X COA.04228.NM Ohio

Profile Details

NPI number 1184707481
LBN Legal business name Long, Loretta
Credentials NMW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Mar 18th, 2021 - about 4 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 1184707481 NPPES
Ohio MEDICAID 2078595

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