MITSI TONETTE LONG (NPI# 1740801752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740801752 |
| Entity Type | Individual |
| Full Name | MITSI TONETTE LONG |
| Credential | PMHNP |
| Practice Address |
3341 Youree Dr Ste 205 Shreveport LA 71105-2149 |
| Mailing Address |
143 Inwood Rd Texarkana TX 75501-8768 |
| Practice Telephone | 3182194167 |
| Mailing Telephone | 9032936679 |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2020-04-30 |
| 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 |
210781 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4606 Lee St, Alexandria, LA 713023235 | 3184411105 |
| Street Address |
3341 YOUREE DR STE 205 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-2149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588039671 | Rosharon Shunta Turner | Counselor | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2015-12-01 |
| 1336787589 | Tina C Evans | Behavior Technician | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2019-12-18 |
| 1548803711 | Renice Rebecca Jackson | Pharmacy Technician | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2019-10-21 |
| 1366003733 | Jermaine Antonio Johnson | Registered Nurse | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2019-06-25 |
| 1134780778 | Donesha Newton | Licensed Practical Nurse | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2019-06-25 |
| 1699331694 | Jacquelyn Ranae Roberson | Licensed Practical Nurse | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2019-05-15 |
| 1194209569 | Sandra Ruth Bates | Registered Nurse | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2018-09-20 |
| 1235630047 | Felicia Sullivan | Licensed Practical Nurse | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2018-02-27 |
| 1164936084 | Latonya Monique Nelson | Licensed Practical Nurse | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2017-11-30 |
| 1598279507 | Antronada Gaines | Case Manager/Care Coordinator | 3341 Youree Dr Ste 205, Shreveport, LA 71105-2149 | 2017-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| 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 |
|---|---|---|---|---|
| 1942660287 | Larry David Allen Jr. | Nurse Practitioner | 4416 Orchid St, Shreveport, LA 71105-3130 | 2016-02-29 |
| 1912389503 | Lisa Jones Baker | Nurse Practitioner | 1002 Highland Ave Fl 2, Shreveport, LA 71101-4143 | 2015-06-19 |
| 1407264989 | Jaschandria Bailey | Nurse Practitioner | Brentwood Hospital, 1006 Highland Avenue, Shreveport, LA 71101-4202 | 2014-07-28 |
| 1851493829 | Susan M Derivas | Nurse Practitioner | 1651 E 70th St # 382, Shreveport, LA 71105-5115 | 2006-09-01 |
| 1518574441 | Jadebrey Vyshette Kennon | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-24 |
| 1104471382 | Juanita Carolyn Roberts | Nurse Practitioner | 1006 Highland Ave, Shreveport, LA 71101-4103 | 2019-08-05 |
| 1841792249 | James G Jones IIi | Nurse Practitioner | 1002 Highland Ave, Shreveport, LA 71101-4143 | 2018-03-02 |
| 1225539984 | Marnitta Demming | Nurse Practitioner | 7591 Fern Ave Ste 1705, Shreveport, LA 71105-5749 | 2018-02-27 |
| 1912417262 | Janey Gaston | Nurse Practitioner | 8731 Park Plaza Dr, Shreveport, LA 71105-5682 | 2017-10-01 |
| 1043601685 | Psychiatric Nurse Practitioner Services, LLC | Nurse Practitioner | 1651 E 70th St # 382, Shreveport, LA 71105-5115 | 2015-02-17 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on MITSI TONETTE 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.