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Individual
JANE A LONGEST
Active
Individual
JANE A LONGEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C5-0000817
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5-0000817
PROFESSIONAL -PHYSICIAN ASSISTANT
DE
Enumeration date
04/12/2010
Last updated
06/17/2019
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