Individual
ANGELA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3240 HOLLAND RD, SUFFOLK, VA 23434-7606
(757) 957-1114
Mailing address
3240 HOLLAND RD, SUFFOLK, VA 23434-7606
(757) 957-1114
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
1401110475
VA
251E00000X
Home Health Agency
1401110475
VA
376K00000X
Nurse's Aide
Primary
1401110475
VA
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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