JENNIFER DIANE LONGSHORE (NPI# 1083222897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083222897 |
| Entity Type | Individual |
| Full Name | JENNIFER DIANE LONGSHORE |
| Credential | PNP- PC |
| Practice Address |
1406 W 17th St Pueblo CO 81003-1927 |
| Mailing Address |
4891 Eckert St Castle Rock CO 80104-5430 |
| Practice Telephone | 7195464928 |
| Mailing Telephone | 9038064166 |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
0995027 | CO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1406 W 17TH ST |
| City | PUEBLO |
| State | CO |
| Zip Code | 81003-1927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700082021 | Christine Marie Cruz | Nurse Practitioner | 1406 W 17th St, Pueblo, CO 81003-1927 | 2007-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164042016 | Sunil Kumar | Student in an Organized Health Care Education/Training Program | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2020-04-21 |
| 1497382303 | Pueblo Family Dentistry Pllc | Dentist | 701 N Grand Avenue, Suite B, Pueblo, CO 81003 | 2020-03-23 |
| 1023654241 | Elmer A. Villalon, Dmd, LLC | Clinic/Center | 1225 North Main Street, #207, Pueblo, CO 81003 | 2019-11-22 |
| 1518434349 | Mariam Rahim | Internal Medicine | Parkview Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-10-30 |
| 1003308222 | Julia Mcneice | Internal Medicine | Parkview Medial Center, Parkveiw Adult Medicine Clinic, 311 West 14th Street, Pueblo, CO 81003 | 2018-06-04 |
| 1689164857 | Jessica Sels | Internal Medicine | Parkview Medical Center Adult Medicine Clinic, 311 W 14th St, Pueblo, CO 81003 | 2018-05-14 |
| 1700313459 | Allison Vigil | Occupational Therapist | 1600 W. 24th St, Pueblo, CO 81003 | 2017-05-12 |
| 1245682020 | Paul S Bongat | Internal Medicine | 411 W. 14th St., Parkview Adult Medicine Clinic, Pueblo, CO 81003 | 2016-07-06 |
| 1013368596 | Daniel R Long | Internal Medicine | 411 West 14th Street, Pueblo, CO 81003 | 2016-06-27 |
| 1396195665 | Parkview Medical Center | General Acute Care Hospital | 411 W. 14th St, Pueblo, CO 81003 | 2016-06-17 |
| Find all providers in zip 81003 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972071306 | Brooke Erin Douglas | Nurse Practitioner | 332 S Orchard Springs Dr Ste 150, Pueblo, CO 81007-6154 | 2018-11-03 |
| 1437600608 | Diana Karnilaw | Nurse Practitioner | 1619 N Greenwood St, Suite 400, Pueblo, CO 81003-2644 | 2016-10-21 |
| 1639416555 | Stephanie L Salbato | Nurse Practitioner | 332 S Orchard Springs Dr, Suite 150, Pueblo, CO 81007-6151 | 2013-01-11 |
| 1053350496 | Pamela L Kubly | Nurse Practitioner | 4112 Outlook Blvd, Suite 255, Pueblo, CO 81008-1667 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144832981 | 4 Corners Children's Clinic | Nurse Practitioner | 555 Rivergate Ste B1-109, Durango, CO 81301-7473 | 2020-08-22 |
| 1922630995 | Ashley Ruth Lahman | Nurse Practitioner | 162 Tartan Dr, Johnstown, CO 80534-7429 | 2020-02-07 |
| 1912543778 | Lauren Wollenzin | Nurse Practitioner | 3548 Dexter Ct, Denver, CO 80207-1050 | 2019-11-26 |
| 1386209294 | Rachel Unruh | Nurse Practitioner | 4880 Thompson Pkwy # 116, Johnstown, CO 80534-6409 | 2019-05-06 |
| 1083186407 | Megan Brady | Nurse Practitioner | 454 S Lafayette St, Denver, CO 80209-2501 | 2018-12-24 |
| 1093299679 | Brittany Michele Nielsen | Nurse Practitioner | 9141 Grant St Ste 115, Thornton, CO 80229 | 2018-09-19 |
| 1073010922 | Amanda Aung | Nurse Practitioner | 7240 Trione Ln, Fountain, CO 80817-2805 | 2018-04-08 |
| 1245737279 | Rebecca A Somershoe | Nurse Practitioner | 8200 E Belleview Ave Ste 510e, Greenwood Village, CO 80111-2808 | 2018-04-06 |
| 1629596168 | Alaina C Vargas | Nurse Practitioner | 502 Ludwig Drive, Bayfield, CO 81122 | 2017-09-05 |
| 1629592803 | Karly Yingst | Nurse Practitioner | 1516 Morning Glow Dr, Windsor, CO 80550 | 2017-07-31 |
| Find all providers with the same taxonomy | ||||
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| 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.