NICOLE LONG (NPI# 1184100067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184100067 |
| Entity Type | Individual |
| Full Name | NICOLE LONG |
| Other Name | NICOLE BRICKLEY |
| Credential | PMHNP |
| Practice Address |
3725 Belfort Rd Jacksonville FL 32216-5813 |
| Mailing Address |
14067 Crestwick Dr W Jacksonville FL 32218-8494 |
| Practice Telephone | 9042961055 |
| Mailing Telephone | 3526310721 |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2018-07-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
9356980 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174634950 | Nicole Long | Nurse Practitioner | 902 Carl Rd, Lafayette, CA 94549-4807 | 2006-08-31 |
| 1679090302 | Nicole Marie Long | Nurse Practitioner | 50 Irving St Nw, Washington, DC 20422-0001 | 2017-08-23 |
| 1336581511 | Nicole Long | Social Worker | 150 West St, West Bridgewater, MA 02379-1448 | 2013-07-29 |
| 1891058939 | Nicole Diane Long | Nurse Practitioner | 2990 Cortez Ave, Idaho Falls, ID 83404-7554 | 2012-06-22 |
| 1851521660 | Nicole C. Long | Optometrist | 320 Central City Plz, New Kensington, PA 15068-6441 | 2009-07-15 |
| 1962609289 | Nicole Ann Long | Obstetrics & Gynecology | 277 White St Ne, Abingdon, VA 24210-2913 | 2007-06-29 |
| 1093834145 | Nicole Ann Long | Nurse Practitioner | 9397 Crown Crest Blvd, Ste 320, Parker, CO 80138-8575 | 2007-03-28 |
| 1386733087 | Nicole Marie Long | Social Worker | 2285 Benden Dr, Wooster, OH 44691-2568 | 2006-10-12 |
| 1750482683 | Nicole L Long | Chiropractor | 4902 Tacoma Mall Blvd, Tacoma, WA 98409-7149 | 2006-09-25 |
| Street Address |
3725 BELFORT RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-5813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346205861 | Daniel Memorial, Inc. | Case Management | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2006-04-18 |
| 1407404007 | Jasmyn C Graham | Marriage & Family Therapist | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2019-08-28 |
| 1750859591 | Tiffany M Haynes | Counselor | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2018-11-09 |
| 1275011645 | Michelle Y Bailey | Counselor | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2018-07-30 |
| 1184134645 | Jennifer Gault Rousset | Social Worker | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2017-10-10 |
| 1972032522 | Christian Senko | Social Worker | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2017-06-07 |
| 1447797493 | Takiyah Joseph | Counselor | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2017-01-30 |
| 1316489230 | Tamara Ramos | Social Worker | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2016-11-09 |
| 1528410149 | Elle Marriott | Counselor | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2016-07-07 |
| 1619343217 | Gregory Pittman | Counselor | 3725 Belfort Rd, Jacksonville, FL 32216-5813 | 2015-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720691843 | Eralene Manangan | Nurse Practitioner | 4205 Belfort Rd Ste 4030, Jacksonville, FL 32216-1475 | 2020-08-28 |
| 1306456025 | Richard Mercer | Nurse Practitioner | 3545 Saint Johns Bluff Rd S Ste 137, Jacksonville, FL 32224-2682 | 2020-08-06 |
| 1467060434 | Rebecca Bertone | Nurse Practitioner | 8540 Turkey Oaks Dr S, Jacksonville, FL 32277-2920 | 2020-07-16 |
| 1861018616 | Octavia J Robertson | Nurse Practitioner | 3562 Boone Park Ave, Jacksonville, FL 32205-8433 | 2020-06-17 |
| 1902428568 | Kimberly J Grant | Nurse Practitioner | 8680 Baymeadows Rd E Apt 1413, Jacksonville, FL 32256-4002 | 2020-05-17 |
| 1447710900 | Shannska Atis | Nurse Practitioner | 580 W 8th St Fl II5, Jacksonville, FL 32209-6533 | 2019-03-21 |
| 1811462237 | Dzenefa Ramic | Nurse Practitioner | 10175 Fortune Pkwy Unit 206, Jacksonville, FL 32256-6748 | 2018-10-11 |
| 1851871024 | Shakhia Grant | Nurse Practitioner | 3636 University Blvd S Ste B, Jacksonville, FL 32216-4223 | 2018-08-17 |
| 1295230845 | Lacey Cawthron | Nurse Practitioner | 8130 Baymeadows Cir W Ste 109, Jacksonville, FL 32256-1837 | 2018-03-27 |
| 1083116107 | Kbn Healthcare, Pllc | Nurse Practitioner | 9471 Baymeadows Rd Ste 3, Jacksonville, FL 32256-7932 | 2018-03-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
Please comment or provide details below to improve the information on NICOLE 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.