MRS. MARDIE ANNE LONG (NPI# 1215244975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215244975 |
Entity Type | Individual |
Full Name | MRS. MARDIE ANNE LONG |
Credential | APRN |
Practice Address |
1415 N Penn Ave Independence KS 67301-0314 |
Mailing Address |
Po Box 314 Independence KS 67301 |
Practice Telephone | 6203312400 |
Practice Fax Number | 6203312405 |
Mailing Telephone | 6203312400 |
Mailing Fax Number | 6203312405 |
Enumeration Date | 2010-09-01 |
Last Update Date | 2016-10-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
75225 | KS | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1415 N PENN AVE |
City | INDEPENDENCE |
State | KS |
Zip Code | 67301-0314 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003251802 | Wilson County Hospital | Clinic/Center | 1415 N Penn Ave, Independence, KS 67301-2222 | 2013-05-07 |
1811205214 | Johnathan A Rodriquez | Nurse Practitioner | 1415 N Penn Ave, Independence, KS 67301 | 2010-09-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417509217 | Lee Ann Gingery | Social Worker | 116 1/2 West Myrtle, Independence, KS 67301 | 2019-07-11 |
1801180070 | Jeffrey Neil Carnes | Counselor | 1101 Donald Avenue, Independence, KS 67301 | 2011-06-06 |
1699099077 | Four County Mental Health Center | Home Health | 415 Fruitland, Independence, KS 67301 | 2010-03-15 |
1558570234 | Rahab M Nduati | Occupational Therapist | 1000 W Mulberry Street, Independence, KS 67301 | 2007-05-21 |
1164639779 | Robert M Osborn Do Pa | Family Medicine | 400 N. 14th St., Independence, KS 67301 | 2007-05-16 |
1619198280 | Michael Alford | Social Worker | 3751 West Main, Independence, KS 67301 | 2007-05-01 |
1699836650 | Dacia Christine Thiele | Social Worker | 200 Arco Suite 501, Independence, KS 67301 | 2006-12-13 |
1134157167 | Carl L Mitchell Jr. | Social Worker | 220 E. Chestnut, Independence, KS 67301 | 2006-06-29 |
1437118239 | Renal Treatment Centers West Inc | Clinic/Center | 801 W Myrtle St, Independence, KS 67301 | 2006-03-21 |
1649767112 | Rachael Dawn Miles | Counselor | 3751 W Main St, Independence, KS 67301 | 2018-04-19 |
Find all providers in zip 67301 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255944815 | Lauren Narduzzi | Nurse Practitioner | 8755 Hillside Rd, Independence, OH 44131-5424 | 2020-08-24 |
1699303735 | Aaron Mccoy | Nurse Practitioner | 11509 Staffordsburg Rd, Independence, KY 41051-7759 | 2020-04-01 |
1851922629 | Integrated Health and Wellness LLC | Nurse Practitioner | 281 Martin Luther King Jr St, Independence, LA 70443-2386 | 2020-01-30 |
1467010298 | Francina Contessa Whitley | Nurse Practitioner | 17020 E Us Highway 40 Ste 5&6, Independence, MO 64055-5361 | 2019-06-05 |
1033777545 | Joshua Clayton Smith | Nurse Practitioner | 12613 E 41st Ter S, Independence, MO 64055-4420 | 2019-05-30 |
1326539578 | Brenton Paul Wagner | Nurse Practitioner | 4801 Acorn Dr Ste B, Independence, OH 44131-2566 | 2018-05-23 |
1649791468 | Danielle Davone Boguslaw | Nurse Practitioner | 4731 S Cochise Dr Ste 100, Independence, MO 64055-6975 | 2017-07-01 |
1063951101 | April Altice | Nurse Practitioner | 815 N Noland Rd Ste 6, Independence, MO 64050-2975 | 2017-02-22 |
1184173924 | Tina Michelle Ross | Nurse Practitioner | 1500 W White Oak St, Independence, MO 64050-2559 | 2016-09-21 |
1477907830 | Christina M Reser | Nurse Practitioner | 16912 E Hart Ave, Independence, MO 64055-3040 | 2016-04-21 |
Find all providers in INDEPENDENCE |
City | INDEPENDENCE |
Zip Code | 67301 |
Please comment or provide details below to improve the information on MRS. MARDIE ANNE 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.