Carol Jean Long

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

17504-31 Issued in WI

Practice address

18404 51St Ave
Chippewa Falls, WI 54729-6839

Phone

(715) 720-7794

NPI assigned

Jan 20, 2016

Last updated

Jan 20, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1093172108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18404 51ST AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547296839",
            "telephone_number": "715-720-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18404 51ST AVE",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547296839",
            "telephone_number": "715-720-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "17504-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina M Lien, MS, LPC
• Ashlyn Kate Lilek, M.A., CCC-SLP
• Martha Joan Lindeman, CAC
• Rachael Lionberger, RDN, CD
• Susan Littfin, PHARMD
• Melissa M. Long, M.S., CCC/SLP
• LTC RX Inc (LTC Rx)
• Michael Gerald Lubahn, DPT, ATC
• Megen M Lube, RDH
• Lutheran Social Services of Wisconsin and Upper Michigan, Inc. (Lutheran Social Services of WI and Upper MI Outpatient Counseling)

• Licensed Practical Nurse in Chippewa Falls, WI
• Providers in Chippewa Falls, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.