Individual
JANE A LONGEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9715 HEALTHWAY DR, BERLIN, MD 21811
(410) 548-2343
(844) 332-3891
Mailing address
PO BOX 3177, SALISBURY, MD 21802-3177
(410) 548-2343
(844) 332-3891
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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