Healthcare Provider Details

I. General information

NPI: 1255756219
Provider Name (Legal Business Name): HILARY A LONG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HILARY ANNE WHITE

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17300 N PERIMETER DR STE 220
SCOTTSDALE AZ
85255-6703
US

IV. Provider business mailing address

10200 GRAND CENTRAL AVE STE 220
OWINGS MILLS MD
21117-4366
US

V. Phone/Fax

Practice location:
  • Phone: 480-661-2661
  • Fax:
Mailing address:
  • Phone: 602-222-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1943
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: