Individual
ASHLEY H. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2025 FRONTIS PLAZA BLVD, SUITE 200, WINSTON SALEM, NC 27103-5663
(336) 768-6211
(336) 768-6869
Mailing address
2025 FRONTIS PLAZA BLVD, SUITE 200, WINSTON SALEM, NC 27103-5663
(336) 768-6211
(336) 768-6869
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-01417
NC MEDICAL LICENSE
NC
Enumeration date
07/03/2008
Last updated
09/15/2011
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