MS. KATHERINE MARIE LONGORIA PNP RN NPI 1275887051

NPI Information

NPI: 1275887051
Provider Name: MS. KATHERINE MARIE LONGORIA, PNP, RN
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
2680 W CENTRE AVE
PORTAGE, MI
ZIP 49024
Phone: (269) 324-2400
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MS. Katherine Marie Longoria, PNP, RN is a pediatrics nurse practitioner in Portage, MI. MS. Katherine Marie Longoria, PNP, RN NPI is 1275887051. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2680 W CENTRE AVE
PORTAGE, MI
ZIP 49024-828
Phone: (269) 324-2400
Fax: (269) 324-0450

The NPI 1275887051 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 11/1/2012 and was last updated on 11/13/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WP0200X	Registered Nurse	Pediatrics	4704250766	MICHIGAN	No
2	363LP0200X	Nurse Practitioner	Pediatrics	4704250766	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1275887051	MEDICAID	MICHIGAN
2	1801818752	OTHER	MICHIGAN	BCBSM - BMG

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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