Holly Jo Long, APRN

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

APRN.CNS.16705 Issued in OH

Practice address

8087 Washington Village Dr Ste 120
Dayton, OH 45458-1873

Phone

(937) 203-4848

Fax

(937) 203-4370

NPI assigned

Feb 2, 2018

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1396244687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 LOFTON DR",
            "city": "ENGLEWOOD",
            "state": "OH",
            "postal_code": "453158739",
            "telephone_number": "937-974-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8087 WASHINGTON VILLAGE DR STE 120",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581873",
            "telephone_number": "937-203-4848",
            "fax_number": "937-203-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "HOLLY",
        "middle_name": "JO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "OH",
            "license": "APRN.CNS.16705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sofia Maria Lombardozzi
• Daniel Lommer, RPH
• Ashley Ann Long, IDMT
• Desire Long
• Elizabeth Long
• Jacob Raymond Long, DO
• Jamie Long, CNP
• Jaylin Doniece Long
• Jennifer Lynn Long, RN
• Kent Charles Long, D.C.

• Gerontology Clinical Nurse Specialist in Dayton, OH
• Providers in Dayton, OH by specialty
• Gerontology Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; 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.