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1497994529
NICOLE MARIE LONGORIA
RALEIGH, NC
NPI
1497994529
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Former Name
NICOLE MARIE KUPINSKI
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: KY 1084959)
Enumeration Date
2009-02-12
Last Update Date
2017-01-05
Business Address
Mrs. NICOLE MARIE LONGORIA P.A.
10207 CERNY ST SUITE 312
RALEIGH, NC 27617-4879
Phone number: 919-670-0302
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Mailing Address
Mrs. NICOLE MARIE LONGORIA P.A.
4355 LYMAN AVE
RALEIGH, NC 27616-8460
Phone number: 931-302-0026
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