Individual
DEANNA LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3850 GRANT AVE STE 200, LOVELAND, CO 80538-8431
(970) 624-5170
(970) 669-7521
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-2404
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0004822
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000142742
—
CO
Enumeration date
10/17/2016
Last updated
08/26/2019
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