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Individual

ANGELA LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1265 HIGHWAY 54 W STE 402, FAYETTEVILLE, GA 30214-4537
(678) 817-6550
Mailing address
8342 HIGHWAY 54, SHARPSBURG, GA 30277-2109

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN208639
GA

Other

Enumeration date
06/18/2017
Last updated
01/22/2021
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