| Stephanie Sue Long, CRNA | |
|
1808 W Main St, Russellville, AR 72801-2724 | |
| (479) 968-2841 | |
| Not Available |
| Full Name | Stephanie Sue Long |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 21 Years |
| Location | 1808 W Main St, Russellville, Arkansas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578534970 | NPI | - | NPPES |
| 771014101 | Other | AR | AR BREASTCARE |
| P00377263 | Other | RR MEDICARE GROUP #CC5970 | |
| 5Y760 | Other | AR | BCBS OF AR |
| 160268001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | CTP161 (Arkansas) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | C01566 (Arkansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Marys Regional Medical Center | Russellville, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Mary's Specialty Llc | 5496189318 | 8 |
| Entity Name | St Mary's Specialty, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831730670 PECOS PAC ID: 5496189318 Enrollment ID: O20200102000443 |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Sue Long, CRNA Po Box 1351, Russellville, AR 72811-1351 Ph: (800) 235-1415 | Stephanie Sue Long, CRNA 1808 W Main St, Russellville, AR 72801-2724 Ph: (479) 968-2841 |
Regina D Prince, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1808 W Main St, Russellville, AR 72801 Phone: 479-968-2841 | |
Hugh Hayden Hipps, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1808 W Main St, Russellville, AR 72801 Phone: 479-968-2841 | |
Mr. Clifford G Breier, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1808 W Main St, Russellville, AR 72801 Phone: 479-968-2841 | |
Mr. Michael W Gund, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1808 W Main St, Russellville, AR 72801 Phone: 479-968-2841 |