Provider Demographics
NPI:1992313001
Name:LONG, MEGHANN (FNP-BC)
Entity type:Individual
Prefix:
First Name:MEGHANN
Middle Name:
Last Name:LONG
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 RURAL ACRES DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3503
Mailing Address - Country:US
Mailing Address - Phone:304-253-2628
Mailing Address - Fax:302-252-1720
Practice Address - Street 1:2157 RITTER DR
Practice Address - Street 2:
Practice Address - City:DANIELS
Practice Address - State:WV
Practice Address - Zip Code:25832-9371
Practice Address - Country:US
Practice Address - Phone:304-763-4326
Practice Address - Fax:304-763-4275
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2025-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV106765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily