MOLLY CATHERINE LONG (NPI# 1164815379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164815379 |
| Entity Type | Individual |
| Full Name | MOLLY CATHERINE LONG |
| Credential | N.P. |
| Practice Address |
3512 Stellhorn Rd Fort Wayne IN 46815-4631 |
| Mailing Address |
Po Box 392552 Pittsburgh PA 15251-9552 |
| Practice Telephone | 2604839081 |
| Practice Fax Number | 2604839196 |
| Mailing Telephone | 2604839081 |
| Mailing Fax Number | 2604369662 |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2018-12-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 28192221A | IN | Nursing Service Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
71005386A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7956 W Jefferson Blvd, Fort Wayne, IN 46804 | 2604362416 | 2604369662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043208523 | Molly M Long | Obstetrics & Gynecology | 603 7th St S, Suite 300, St Petersburg, FL 33701-4719 | 2005-10-10 |
| 1508196551 | Molly Marie Long | Social Worker | 1400 Emeline Ave Bldg K, Santa Cruz, CA 95060-1976 | 2010-01-13 |
| Street Address |
3512 STELLHORN RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-4631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962490839 | Peggy A Ryan | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2005-10-13 |
| 1952915951 | Bambi Michelle Cardinal | Registered Nurse | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-09-07 |
| 1700408648 | Madalene Beckner | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-05-14 |
| 1013536358 | Chanel Burns | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-04-15 |
| 1033742184 | Hamutyinei H Mamutse | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-02-18 |
| 1285273573 | Abimbola D Oluwasesin | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2020-01-03 |
| 1912553652 | Kara Hawkins | Social Worker | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2019-08-16 |
| 1558923417 | Todd Shaw | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2019-07-01 |
| 1548828338 | Deanna Forsythe | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2019-06-05 |
| 1629636089 | Nathan Call | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2019-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548626229 | Tina Duncan | Nurse Practitioner | 6732 Covington Creek Trl, Fort Wayne, IN 46804-2870 | 2016-01-11 |
| 1538486691 | Rounding Providers | Nurse Practitioner | 14411 Smugglers Notch, Fort Wayne, IN 46814-8701 | 2010-04-29 |
| 1245428366 | Damon Greven | Nurse Practitioner | 2512 E Dupont Rd Ste 100, Fort Wayne, IN 46825-1609 | 2007-10-15 |
| 1467658740 | Kimberly E Recht | Nurse Practitioner | 11108 Parkview Circle, Suite 5100, Fort Wayne, IN 46845 | 2007-06-25 |
| 1083827539 | Ruth Elaine Wartell | Nurse Practitioner | 8107 Tranquilla Pl, Fort Wayne, IN 46815-5781 | 2007-05-08 |
| 1285756874 | Timothy John Murphy | Nurse Practitioner | 3617 Rockwood Dr, Fort Wayne, IN 46815-6144 | 2007-04-04 |
| 1962490839 | Peggy A Ryan | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2005-10-13 |
| 1265095897 | Ashley Kamea Lynn Brown | Nurse Practitioner | 6326 Constitution Dr, Fort Wayne, IN 46804-1518 | 2019-04-18 |
| 1104398833 | Jessica Marie Bolton | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815 | 2018-12-19 |
| 1750868568 | Shannon E Sitgreaves | Nurse Practitioner | 3512 Stellhorn Rd, Fort Wayne, IN 46815-4631 | 2018-07-24 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
Please comment or provide details below to improve the information on MOLLY CATHERINE LONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.