Provider Demographics
NPI:1699466045
Name:LONGSHIP NURSING AND CONSULTING LLC
Entity type:Organization
Organization Name:LONGSHIP NURSING AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:907-854-6877
Mailing Address - Street 1:PO BOX 672154
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-2154
Mailing Address - Country:US
Mailing Address - Phone:907-854-6877
Mailing Address - Fax:
Practice Address - Street 1:21249 OLD GLENN HIGHWAY (MOBILE PRACTICE)
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567
Practice Address - Country:US
Practice Address - Phone:907-854-6877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty