LARA MADISON LONG (NPI# 1265910269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265910269 |
| Entity Type | Individual |
| Full Name | LARA MADISON LONG |
| Credential | NP |
| Practice Address |
1265 S Utica Ave Tulsa OK 74104-4243 |
| Mailing Address |
9228 S Mingo Rd Ste 200 Tulsa OK 74133-5722 |
| Practice Telephone | 9185920999 |
| Practice Fax Number | 9185921021 |
| Mailing Telephone | 9185920999 |
| Mailing Fax Number | 9185921021 |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 103047 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962053702 | Lara Long | Counselor | 1000 Westbank Dr Ste 6, West Lake Hills, TX 78746-6598 | 2019-09-23 |
| 1205037967 | Lara Michelle Long | Chiropractor | 5901 Roosevelt Way Ne Ste 101a, Seattle, WA 98105-2763 | 2007-05-30 |
| Street Address |
1265 S UTICA AVE |
| City | TULSA |
| State | OK |
| Zip Code | 74104-4243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124829 | Deanene K Tonn | Physician Assistant | 1265 S Utica Ave, Ste 300, Tulsa, OK 74104-4243 | 2005-06-17 |
| 1790318426 | Pavel Greg Buzadzhi | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2020-02-21 |
| 1447735055 | Jonathan Daniel Bouldin | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-09-28 |
| 1760969497 | Megan L Vitrano | Clinical Nurse Specialist | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-07-25 |
| 1790262012 | Brooke Nichol Weaver | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-07-20 |
| 1013409945 | Kristopher Wayne Mcdonald | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-06-06 |
| 1942797238 | Jay W Vazquez | Nurse Practitioner | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2018-04-23 |
| 1861937013 | Kelleigh Deeann Sprott | Physician Assistant | 1265 S Utica Ave, Tulsa, OK 74104-4243 | 2016-12-27 |
| 1083071534 | Eugenia Lynn Pulliam | Physician Assistant | 1265 S Utica Ave, Suite 300, Tulsa, OK 74104-4243 | 2016-01-27 |
| 1568827426 | Ashley Nichole Cornett | Physician Assistant | 1265 S Utica Ave, Suite 300, Tulsa, OK 74104-4243 | 2015-12-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
| 1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
| 1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
| 1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
| 1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
| 1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
| 1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
| 1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
| 1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
| 1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
| Find all providers in zip 74104 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700403037 | Molly Lewis | Nurse Practitioner | 9001 S 101st East Ave Ste 230, Tulsa, OK 74133-5797 | 2020-07-02 |
| 1861036055 | Carmen Gabriela Nateras | Nurse Practitioner | 5970 E 31st St Ste I, Tulsa, OK 74135-5112 | 2019-10-31 |
| 1699323097 | Leslie Burton | Nurse Practitioner | 7912 E 31st Ct Ste 320, Tulsa, OK 74145-1305 | 2019-08-28 |
| 1902361538 | Jonathan Michael Ranck | Nurse Practitioner | 3430 E 87th Pl, Tulsa, OK 74137-2637 | 2019-02-07 |
| 1003397332 | Adekemi Taiwo | Nurse Practitioner | Hillcrest South Medical Plaza, 8803 S. 101 St E. Ave. Suite 350, Tulsa, OK 74133 | 2018-08-24 |
| 1326527060 | Kelly Watson | Nurse Practitioner | 6802 S Olympia Ave Ste 300, Tulsa, OK 74132-1826 | 2018-08-13 |
| 1104287713 | Christina Hynes | Nurse Practitioner | 2000 S Wheeling Ave Ste 600, Tulsa, OK 74104-5645 | 2016-03-09 |
| 1447660303 | Cecilia Shaw | Nurse Practitioner | 3159 S Madison Ave, Tulsa, OK 74105-2035 | 2014-04-30 |
| 1609139153 | Jessica Ann Brewer | Nurse Practitioner | 2907 S Boston Ct, Tulsa, OK 74114-5214 | 2012-06-20 |
| 1306138896 | Matrix Medical Network of Oklahoma LLC | Nurse Practitioner | 8211 E Regal Pl Ste 100-103, Tulsa, OK 74133-7167 | 2011-05-03 |
| Find all providers in TULSA | ||||
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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.