Individual
JESSE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 PATEWOOD DR STE B350, GREENVILLE, SC 29615-6337
(864) 454-4500
(864) 454-4505
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26834
SC
Other
Enumeration date
04/03/2023
Last updated
05/10/2023
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