MS. MIRANDA BROOKE LONG (NPI# 1336708163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336708163 |
| Entity Type | Individual |
| Full Name | MS. MIRANDA BROOKE LONG |
| Credential | ARNP |
| Practice Address |
800 Prudential Dr Jacksonville FL 32207-8211 |
| Mailing Address |
655 W 8th St # C-3 Jacksonville FL 32209-6511 |
| Practice Telephone | 9042021083 |
| Mailing Telephone | 9042443508 |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LN0005X |
Nurse Practitioner Specialization: Neonatal, Critical Care |
APRN11002616 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
11002616 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467010868 | Miranda Karleen Long | Student in an Organized Health Care Education/Training Program | 2700 Napoleon Ave, New Orleans, LA 70115-6914 | 2019-05-31 |
| 1245742352 | Miranda C Long | Family Medicine | 101 E Miller Rd, Sterling, IL 61081-1252 | 2017-10-30 |
| Street Address |
800 PRUDENTIAL DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013913854 | Annette Davidson Bell | Family Medicine | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2005-06-27 |
| 1508467523 | Heather Smith | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-11-05 |
| 1306446638 | Jessica Schilz | Dietitian, Registered | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-10-27 |
| 1033718747 | Kiara Michelle Simmons | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-10-22 |
| 1477151488 | Nicole Schumaker | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-10-12 |
| 1609482868 | Anna D Denson | Nurse Practitioner | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-09-22 |
| 1578179453 | Emily Guan Duani | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-09-16 |
| 1487264636 | Heidi Marie Rebholz | Registered Nurse | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-08-03 |
| 1326657982 | Everrenz Health, Inc | Family Medicine | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-07-29 |
| 1760090302 | Matthew Ryan Jones | Anesthesiologist Assistant | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2020-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 363LN0005X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Neonatal, Critical Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482868 | Anna D Denson | Nurse Practitioner | 800 Prudential Dr, Jacksonville, FL 32207-8211 | 2020-09-22 |
| 1235638305 | Megann Colwell Spore | Nurse Practitioner | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2018-02-05 |
| 1235663303 | Vickie Chapman-shaw | Nurse Practitioner | 14550 Old Saint Augustine Rd, Nicu, Jacksonville, FL 32258-2460 | 2017-04-17 |
| 1497288633 | Melissa Usina Fogarty | Nurse Practitioner | 655 W 8th St, Jacksonville, FL 32209-6511 | 2017-04-05 |
| 1740722859 | Crystal Branan Raines | Nurse Practitioner | 655 W 8th St, Jacksonville, FL 32209-6511 | 2016-11-07 |
| 1336533181 | Kathryn Lemaire Thomas | Nurse Practitioner | 800 Prudential Dr, Jacksonville, FL 32207-8202 | 2015-03-18 |
| 1447556691 | Sue Hartman | Nurse Practitioner | 120 Memorial Dr, Jacksonville, NC 28546-6328 | 2011-02-07 |
| 1013196310 | Jessica Jeanne Mcelhose | Nurse Practitioner | 655 W 8th St, Ufjp - Dept. of Peds/neonatology, Jacksonville, FL 32209-6511 | 2007-11-02 |
| 1154533420 | Mary Elizabeth Dehay | Nurse Practitioner | 4205 Belfort Rd, 4090, Jacksonville, FL 32216-1471 | 2007-05-07 |
| 1275619850 | Deborah Carter Fulop | Nurse Practitioner | 4205 Belfort Rd, Suite 4090, Jacksonville, FL 32216-1471 | 2006-10-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on MS. MIRANDA BROOKE 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.