Provider Demographics
NPI:1225601750
Name:LONG, CAROLINE GRACE (PA)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:GRACE
Last Name:LONG
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Gender:F
Credentials:PA
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Mailing Address - Street 1:465 N BELAIR RD STE 2E
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3190
Mailing Address - Country:US
Mailing Address - Phone:706-855-5510
Mailing Address - Fax:706-855-7254
Practice Address - Street 1:465 N BELAIR RD STE 2E
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3190
Practice Address - Country:US
Practice Address - Phone:706-855-5510
Practice Address - Fax:706-855-7254
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant