Individual
MRS. NICOLE ROSE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, AGNP-C
Contact information
Practice address
3480 WAKE FOREST RD STE 204, RALEIGH, NC 27609-7376
(919) 862-5093
(919) 862-5605
Mailing address
3480 WAKE FOREST RD STE 204, RALEIGH, NC 27609-7376
(919) 862-5093
(919) 862-5605
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5022175
NC
Other
Enumeration date
01/16/2025
Last updated
03/16/2026
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