Long, Matthew S

Long, Matthew S is an individual health care provider with primary practice located at 17C Brentshire Square , Jackson TN 38305-2273. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Long, Matthew S can be contacted via phone (731) 664-1717.

Contact Information

Primary practice address
17C Brentshire Square Jackson TN 38305-2273
Phone: (731) 664-1717
Fax: (731) 664-7114
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN0000067803 Tennessee
Nursing Service Providers / Registered Nurse 163W00000X RN0000057803 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN0000009329 Tennessee

Profile Details

NPI number 1093707945
LBN Legal business name Long, Matthew S
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated May 21st, 2020 - 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 1093707945 NPPES
Tennessee MEDICAID 3607376
Tennessee MEDICAID 1521318

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