Individual
CALINE DAUN LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5000 MEMORIAL DR, TWO RIVERS, WI 54241
(920) 794-5125
(920) 794-5465
Mailing address
1035 KEPLER DR, GREEN BAY, WI 54311-8320
(920) 490-9046
(920) 405-8005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03270
NC
363A00000X
Physician Assistant
Primary
4310
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851663017
—
WI
Enumeration date
02/03/2012
Last updated
04/28/2026
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