Long, Angela Grace

Long, Angela Grace is an individual health care provider with primary practice located at 3201 N Van Buren St Ste 350 , Enid OK 73703-1814. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Long, Angela Grace can be contacted via phone (580) 366-0844.

Contact Information

Primary practice address
3201 N Van Buren St Ste 350 Enid OK 73703-1814
Phone: (580) 366-0844
Fax: (580) 297-5197
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4519 Oklahoma

Profile Details

NPI number 1962824086
LBN Legal business name Long, Angela Grace
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2014
Last updated Oct 31st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962824086 NPPES
Oklahoma Other 1O8717 MEDICARE PTAN
Oklahoma MEDICAID 200984110A MEDICARE PTAN

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