Provider Demographics
NPI:1841660347
Name:LONG, JAMES D (ARNP-C)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:LONG
Suffix:
Gender:M
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9279
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-9279
Mailing Address - Country:US
Mailing Address - Phone:239-601-5055
Mailing Address - Fax:239-204-3861
Practice Address - Street 1:2462 SUTHERLAND CT
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-3188
Practice Address - Country:US
Practice Address - Phone:716-628-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-28
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9290513363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily