MEDICARE: KAREN LONG PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1942605043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LONG PA-C

Provider Business Mailing Address
First Line	:	450 GIBNER RD STE 1
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17013-5086
Country	:	US
Telephone Number	:	177-245-3404
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 GIBNER RD STE 1
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17013-5086
Country	:	US
Telephone Number	:	177-245-3404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2014
Last Update Date	:	08/28/2024

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Directions to “ KAREN LONG PA-C” Practice Location

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