Healthcare Provider Details

I. General information

NPI: 1033112008
Provider Name (Legal Business Name): SARAH BROWNE LONG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 E GREENVILLE ST STE 3850
ANDERSON SC
29621-1580
US

IV. Provider business mailing address

2000 E GREENVILLE ST STE 3850
ANDERSON SC
29621-1580
US

V. Phone/Fax

Practice location:
  • Phone: 864-225-5667
  • Fax: 864-716-6158
Mailing address:
  • Phone: 864-225-5667
  • Fax: 864-716-6158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN589
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR61533
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: