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Contact Information

LISA C LONG, RN
1035 CHERAW ST
BENNETTSVILLE, SC29512
 Phone: 843-454-0442
 Fax: 843-454-0212
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric/Mental Health

163WP0808X
Indicates primary specialty

NPI Profile & details for LISA C LONG · (Female)

NPI Number 1679897797
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 03/18/2010
Last updated 03/18/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 212783
  • SC Medicaid 405127
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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