Provider Demographics
NPI:1841359007
Name:LONG, DARLENE G (NP)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:G
Last Name:LONG
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:8671 S QUEBEC ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-5861
Mailing Address - Country:US
Mailing Address - Phone:303-805-7477
Mailing Address - Fax:038-057-4783
Practice Address - Street 1:8671 S QUEBEC ST STE 200
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-5861
Practice Address - Country:US
Practice Address - Phone:303-805-7477
Practice Address - Fax:038-057-4783
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO4751363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO43076777Medicaid
CO43076777Medicaid