Johnna Nicco Long, FNP | |
101 Greenhorn Ave, Eagle, CO 81631-6040 | |
(970) 389-7353 | |
Not Available |
Full Name | Johnna Nicco Long |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 101 Greenhorn Ave, Eagle, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1447918800 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | APN.0997169-NP (Colorado) | Primary |
Entity Name | Valley View Hospital Association |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1730897109 PECOS PAC ID: 1850294778 Enrollment ID: O20040129000027 |
Entity Name | Colorado Mountain Medical, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1730747445 PECOS PAC ID: 5496087181 Enrollment ID: O20191030000595 |
Mailing Address | Practice Location Address |
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Johnna Nicco Long, FNP Po Box 181, Eagle, CO 81631-0181 Ph: (970) 389-7353 | Johnna Nicco Long, FNP 101 Greenhorn Ave, Eagle, CO 81631-6040 Ph: (970) 389-7353 |
Sarah Wilson, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 377 Sylvan Lake Rd Ste 210, Eagle, CO 81631 Phone: 709-266-3409 Fax: 970-926-6348 | |
Sarah Gabriel, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 137 Howard Street, Eagle, CO 81632 Phone: 970-328-6969 |