Provider Demographics
NPI:1033112008
Name:LONG, SARAH BROWNE (APRN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BROWNE
Last Name:LONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E GREENVILLE ST
Mailing Address - Street 2:STE 3850
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-225-5667
Mailing Address - Fax:864-716-6158
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:STE 3850
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-225-5667
Practice Address - Fax:864-716-6158
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCAPN589363LF0000X
SCR61533163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1051Medicaid
SCQ31759Medicare UPIN
8653Medicare PIN
SCNP1051Medicaid