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Individual

MS. ANGELA GRACE LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3201 N VAN BUREN ST STE 350, ENID, OK 73703-1814
(580) 366-0844
(580) 297-5197
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4519
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200984110A
OK
Enumeration date
01/08/2014
Last updated
11/05/2025
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