person
Ms. Katherine Marie Longoria, PNP,RN
Pediatric Nurse Practitioner in Portage, Michigan
NPI 1275887051

Katherine Marie Longoria is a Pediatric Nurse Practitioner based in Portage, MI and is specialized in Pediatrics. Katherine Marie Longoria practices in Portage, MI and has the professional credentials of PNP,RN. The NPI Number for Katherine Marie Longoria is 1275887051 and holds a License No. 4704250766 (Michigan).

The current practice location address for Katherine Marie Longoria is 2680 W Centre Ave, Portage, MI and can be reached out via phone at 269-324-2400 and via fax at 269-324-0450.

Location: 2680 W Centre Ave, Portage, MI, 49024-4828
person
Provider Profile Details
NPI Number
1275887051
Provider Name
Katherine Marie Longoria
Credential
PNP,RN
Provider Entity Type
Individual
Gender
Female
Address
2680 W Centre Ave, Portage, MI, 49024-4828
Phone Number
269-324-2400
Fax Number
269-324-0450
Provider Enumeration Date
11/01/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1275887051 05 MI
1801818752 01 MI BCBSM - BMG
institution
Provider Business Practice Location Address Details
Address
2680 W Centre Ave
City
State
Zip
49024-4828
Phone Number
269-324-2400
Fax Number
269-324-0450
person
Provider Business Mailing Address Details
Address
2680 W Centre Ave
City
State
Zip
49024-4828
Phone Number
269-324-2400
Fax Number
269-324-0450
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Pediatrics
Taxonomy
License No.
4704250766 (Michigan)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
4704250766 (Michigan)
Definition
Definition to come...
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