Individual
KAYLA DANIELLE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-8000
Mailing address
1123 SUMMIT WEST DR, MORRISVILLE, NC 27560-6948
(336) 695-7995
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0010-13615
NC
Other
Enumeration date
09/11/2023
Last updated
11/26/2024
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