MS. KELLY PATRICIA LONG (NPI# 1447551817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1447551817 |
Entity Type | Individual |
Full Name | MS. KELLY PATRICIA LONG |
Credential | APRN, CPNP |
Practice Address |
900 E 13th St Suite 101 Grove OK 74344-2975 |
Mailing Address |
5300 N Independence Ave 280 Oklahoma City OK 73112-5556 |
Practice Telephone | 9187869900 |
Practice Fax Number | 9187869904 |
Mailing Telephone | 9187869900 |
Mailing Fax Number | 9187869904 |
Enumeration Date | 2010-11-16 |
Last Update Date | 2017-04-05 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
61374 | OK | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | 200311440A | 05 | |
OK | 200505990H | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013551894 | Kelly Denise Long | Physical Therapist | 6410 Diamond Rock Dr, Katy, TX 77449-4241 | 2019-11-04 |
1316319148 | Kelly Long | Occupational Therapist | 1906 Kenwood Ave, Charlotte, NC 28205-3646 | 2015-10-20 |
1013189703 | Kelly Elizabeth Long | Counselor | 115 W 5th, Emporia, KS 66801 | 2008-04-02 |
1720649676 | Kelly Long | Licensed Vocational Nurse | 2180 Valley Blvd, Pomona, CA 91768-3325 | 2019-06-21 |
1366949539 | Kelly Mckinley Long | Student in an Organized Health Care Education/Training Program | 477 Cooper Rd Ste 300, Westerville, OH 43081-8057 | 2018-04-12 |
1871808303 | Kelly A Long | Nurse Practitioner | 1025 Straka Ter, Oklahoma City, OK 73139-2544 | 2010-08-09 |
1447408133 | Kelly Long | Counselor | 615 Shipyard Blvd, Wilmington, NC 28412 | 2008-09-05 |
1568623338 | Kelly Lynn Long | Physician Assistant | 10909 Hannan Rd, Romulus, MI 48174-1383 | 2008-06-24 |
1457564726 | Kelly Long | Counselor | 15303 St. Rt 170, East Liverpool, OH 43920-9216 | 2007-05-07 |
1457438905 | Kelly Ann Long | Audiologist | 15 Exchange Dr, Lugoff, SC 29078-9198 | 2006-11-01 |
Street Address |
900 E 13TH ST SUITE 101 |
City | GROVE |
State | OK |
Zip Code | 74344-2975 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063411536 | Paul Edward Callicoat Jr. | Internal Medicine | 900 E 13th St, Suite 200, Grove, OK 74344-2975 | 2005-07-18 |
1083049001 | Osu Center for Health Sciences | Clinic/Center | 900 E 13th St, Suite 201, Grove, OK 74344-2976 | 2013-09-10 |
1639511157 | Tessa Lynn Longan | Nurse Practitioner | 900 E 13th St, Suite 205, Grove, OK 74344-2975 | 2013-07-25 |
1326304643 | Ashley Shelley | Obstetrics & Gynecology | 900 E 13th St, Suite 205, Grove, OK 74344-2975 | 2012-04-11 |
1598904526 | Kioumars (none) Zarintash | Family Medicine | 900 E 13th St, 104, Grove, OK 74344-2975 | 2009-02-15 |
1851555239 | Tyson Richard Trimble | Orthopaedic Surgery | 900 E 13th St, Suite 104, Grove, OK 74344-2975 | 2008-07-15 |
1316092182 | Renee J Russell Md Inc | Family Medicine | 900 E 13th St, Suite 104, Grove, OK 74344-2975 | 2007-01-24 |
1619041720 | Osu Center for Health Sciences | Clinic/Center | 900 E 13th St, Suite 201, Grove, OK 74344-2975 | 2006-11-20 |
1124030002 | James B Chapman | Internal Medicine | 900 E 13th St, Suite 200, Grove, OK 74344-2975 | 2006-08-12 |
1326067174 | Douglas Allen Ohlstrom | Surgery | 900 E 13th St, Suite 102, Grove, OK 74344-2975 | 2006-07-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326604935 | Deborah Stauss | Massage Therapist | 2086 S Main St, Grove, OK 74344 | 2019-05-20 |
1841776705 | Progressive Orthotic & Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 10 E 6th St., Grove, OK 74344 | 2018-07-13 |
1205329232 | Andra Renee Mitchell | Speech-Language Pathologist | 825 E Third Street, Grove, OK 74344 | 2018-06-13 |
1861996217 | Jenniffer Colleen Clark I | Case Manager/Care Coordinator | 1115 Har-ber Rd, Grove, OK 74344 | 2018-03-21 |
1417458167 | Jason S Beckham | Case Manager/Care Coordinator | 32600 S. 625 Road, Grove, OK 74344 | 2018-02-27 |
1659872034 | Keli Elaine Whitlock | Peer Specialist | 5602 Us Hwy 59, Grove, OK 74344 | 2018-02-22 |
1851899454 | Nichole Marie Wooton | Case Manager/Care Coordinator | 1115 Har-ber Road, Grove, OK 74344 | 2018-01-29 |
1043766645 | Samantha Lane | Speech-Language Pathologist | 1046 Hillside Road, Grove, OK 74344 | 2016-09-01 |
1376927509 | Matthew Kyle Allen | Physical Therapy Assistant | 4621 Hwy 59 N, Grove, OK 74344 | 2015-07-17 |
1477807428 | Andrew Scott Littlejohn | Physical Therapy Assistant | 103 Harber Road, Grove, OK 74344 | 2012-10-30 |
Find all providers in zip 74344 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396383378 | Lindsey Lauren Givens | Nurse Practitioner | 17513 Aragon Ln, Oklahoma City, OK 73170-9209 | 2019-12-20 |
1801453493 | Anna Pauline Reed | Nurse Practitioner | 110 Nw 31st St, Suite 201, Lawton, OK 73505-6100 | 2019-05-20 |
1639631781 | April Keith | Nurse Practitioner | 11204 Katie Beth Cir, Oklahoma City, OK 73170-8403 | 2019-04-05 |
1861950735 | Michelle Kathleen Spehr | Nurse Practitioner | 3231 Healthplex Dr., Norman, OK 73072 | 2019-03-08 |
1740756840 | Darshi Wickrama Edirisooriya | Nurse Practitioner | 1001 N Florence Ave, Claremore, OK 74017-6207 | 2018-10-17 |
1922518232 | Bryan Marshall Tison | Nurse Practitioner | 2000 E 15th St Ste 400a, Edmond, OK 73013-6673 | 2017-10-02 |
1326566001 | Minor Pediatrics Kristie Minor Aprn-cnp Pllc | Nurse Practitioner | 29334 N 3950 Rd, Ochelata, OK 74051-2485 | 2017-09-01 |
1235667833 | Bobbie Renee Stamps | Nurse Practitioner | 18216 S 410 Rd, Hulbert, OK 74441-1832 | 2017-05-25 |
1467984781 | Lauryn Kathleen Trepp | Nurse Practitioner | 2800 W 91st St, Tulsa, OK 74132-3510 | 2017-03-28 |
1760922678 | Carissa Declerck | Nurse Practitioner | 1200 Childrens Ave Ste 2f, Oklahoma City, OK 73104-4637 | 2017-02-27 |
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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.