Active NPI
Paula Irene Long, COSMET HAIR REPLACEM
- Other Technician
- Beckley, WV
National Provider Identifier
1962643494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 030306
- Practice address
- 407 Spruce LN
Beckley, WV 25801-2573 - Phone
- (304) 237-6904
- NPI assigned
- Mar 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | 030306 | WV | Primary |
Addresses
Primary practice location
407 Spruce LN
Beckley, WV 25801-2573
Mailing address
407 Spruce LN
Beckley, WV 25801-2573
Phone (304) 237-6904
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030306 | WV | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236816000000",
"number": "1962643494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 SPRUCE LN",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258012573",
"telephone_number": "304-237-6904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 SPRUCE LN",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258012573",
"telephone_number": "304-237-6904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "PAULA",
"middle_name": "IRENE",
"name_prefix": "Ms.",
"credential": "COSMET HAIR REPLACEM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-12",
"last_updated": "2009-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "WV",
"license": "030306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.