KATHLEEN A LONG (NPI# 1831113026) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831113026 |
| Entity Type | Individual |
| Full Name | KATHLEEN A LONG |
| Credential | APRN-BC, ND |
| Practice Address |
420 W 4th St Mishawaka IN 46544-1948 |
| Practice Telephone | 5743077673 |
| Practice Fax Number | 5743077692 |
| Mailing Telephone | 5743077673 |
| Mailing Fax Number | 5743077692 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2019-01-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71001562A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200441170 | 05 | |
| IN | BCBS | 000000878026 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346743911 | Kathleen Long | Physician Assistant | 2468, 75 Nielson St, Watsonville, CA 95076 | 2018-03-09 |
| 1720346372 | Kathleen Ellen Long | Speech-Language Pathologist | 11142 S Campbell Ave, Chicago, IL 60655-1316 | 2012-05-01 |
| 1184873259 | Kathleen Long | Acupuncturist | 1137 Second St., #116, Santa Monica, CA 90403 | 2008-09-15 |
| 1407821648 | Kathleen Long | Psychologist | 508 Gray Rd, Windham, ME 04062-4831 | 2006-02-21 |
| 1538139068 | Kathleen Adele Long | Nurse Practitioner | 300 E 8th St Ste 120, Marietta, OH 45750-3379 | 2006-01-26 |
| 1043215403 | Kathleen A. Long | Internal Medicine | 144 Bill Carruth Pkwy Ste 3100, Hiram, GA 30141-3819 | 2005-06-14 |
| 1558998633 | Kathleen Long | Student in an Organized Health Care Education/Training Program | 4461 State Route 159 Ste A, Chillicothe, OH 45601-6000 | 2020-03-26 |
| 1083176788 | Kathleen Long | Student in an Organized Health Care Education/Training Program | 506 6th St, Brooklyn, NY 11215-3609 | 2019-04-02 |
| 1710367503 | Kathleen Ann Long | Dermatology | 800 Hospital Dr, Columbia, MO 65201-5275 | 2015-06-05 |
| 1295087252 | Kathleen Long | Community Health Worker | 934 S Main St, Layton, UT 84041-7135 | 2012-10-15 |
| Street Address |
420 W 4TH ST |
| City | MISHAWAKA |
| State | IN |
| Zip Code | 46544-1948 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043266653 | Dale Dennis Deardorff | Family Medicine | 420 W 4th St, Suite 180, Mishawaka, IN 46544-1948 | 2006-05-25 |
| 1952913279 | Joshua Daniel Avery | Nurse Practitioner | 420 W 4th St, Mishawaka, IN 46544-1948 | 2020-08-18 |
| 1013546266 | Monica A Rivers | Pharmacist | 420 W 4th St, Mishawaka, IN 46544-1948 | 2020-04-08 |
| 1740811264 | Kristen Michelle Bessler | Pharmacist | 420 W 4th St, Mishawaka, IN 46544-1948 | 2020-02-03 |
| 1922648476 | Healthlinc Pharmacy LLC | Pharmacy | 420 W 4th St, Mishawaka, IN 46544-1948 | 2020-01-13 |
| 1275041865 | Samantha Lynn Jester | Advanced Practice Midwife | 420 W 4th St, Mishawaka, IN 46544-1948 | 2018-01-17 |
| 1851748693 | Erica Garrett | Advanced Practice Midwife | 420 W 4th St, Mishawaka, IN 46544-1948 | 2016-05-23 |
| 1104281583 | Ashley Marie Thiele | Internal Medicine | 420 W 4th St, Mishawaka, IN 46544-1948 | 2015-12-29 |
| 1023487428 | Jana Schenkel | Advanced Practice Midwife | 420 W 4th St, Mishawaka, IN 46544-1948 | 2015-09-16 |
| 1306241187 | Debra Ellen Neubauer | Registered Nurse | 420 W 4th St, Mishawaka, IN 46544-1948 | 2014-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692676 | Lynnette Markowicz | Occupational Therapist | 1540 S. Logan St, Mishawaka, IN 46544 | 2020-09-08 |
| 1902429822 | Hellenic Senior Living of Mishawaka LLC | Assisted Living Facility | 1540 S. Logan Street, Mishawaka, IN 46544 | 2020-05-27 |
| 1184275422 | Lorrajean A Gleva | Technician | 203 Eastgate Circle, Mishawaka, IN 46544 | 2019-09-27 |
| 1376072785 | Aims, LLC | Psychologist | 1113 Mossy Lane, Mishawaka, IN 46544 | 2017-06-08 |
| 1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
| 1598153355 | Hearing Aid Service | Hearing Instrument Specialist | 3718 Lincolnway E, Mishawaka, IN 46544 | 2015-01-02 |
| 1437587953 | Christopher Ryan Hazel | Dentist | 544 Lincolnway West, Mishawaka, IN 46544 | 2013-10-18 |
| 1699015941 | Frank Walerko | Urology | 809 Bittersweet Cove Drive, Mishawaka, IN 46544 | 2013-02-25 |
| 1023251337 | Josephine Schimizzi | Family Medicine | 1505 South Spring Street, Mishawaka, IN 46544 | 2009-04-16 |
| 1881831147 | Walgreen Co | Pharmacy | 4620 Lincolnway E, Mishawaka, IN 46544 | 2009-01-08 |
| Find all providers in zip 46544 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467092908 | Tori Driver | Nurse Practitioner | 3005 Grape Rd Ste B, Mishawaka, IN 46545-2709 | 2020-01-13 |
| 1093272593 | Regina Lynn Yoder | Nurse Practitioner | 303 S Main St Ste 111, Mishawaka, IN 46544-2159 | 2019-02-21 |
| 1376021725 | Kaley Michelle Marino | Nurse Practitioner | 1113 Mossy Ln, Mishawaka, IN 46544-9055 | 2018-07-29 |
| 1386192870 | Melinda C Nwanganga | Nurse Practitioner | 4501 Lincolnway E, Mishawaka, IN 46544-4035 | 2016-09-14 |
| 1760835912 | Ophelia Ansari | Nurse Practitioner | 4501 Linconway East, Mishawaka, IN 46544 | 2016-07-22 |
| 1457730038 | Melissa Anne Douthit | Nurse Practitioner | 3665 Park Pl W Ste 300, Mishawaka, IN 46545 | 2015-05-28 |
| 1578692794 | Lynn Davis Figg | Nurse Practitioner | 611 East Douglas Road, Suite 405, Mishawaka, IN 46545-1468 | 2007-03-05 |
| 1376557702 | Patricia L Jackson | Nurse Practitioner | 230 W Catalpa Dr, Suite D, Mishawaka, IN 46545-8321 | 2006-07-28 |
| 1467406074 | Saint Joseph Regional Medical Center, Inc. | Nurse Practitioner | 60101 Bodnar Blvd Ste 100b, Mishawaka, IN 46544-9340 | 2006-05-19 |
| 1518955327 | Tori Dawn Clabaugh | Nurse Practitioner | 316 Indian Ridge Blvd, Mishawaka, IN 46545-9034 | 2005-10-06 |
| Find all providers in MISHAWAKA | ||||
Please comment or provide details below to improve the information on KATHLEEN A 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.