Krystal Lasha Long, MSN, APRN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Counce, Tennessee. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Family Clinic At The Lake Pllc and her current practice location is
11268 Highway 57, Counce, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(731) 689-4357.
Krystal Lasha Long is licensed to practice in Tennessee (license number APN28080) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1528637493.
Provider's Profile
Full Name | Krystal Lasha Long |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Experience | 4 Years |
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Location | 11268 Highway 57, Counce, Tennessee |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Krystal Lasha Long graduated from nursing school in 2020
NPI Data:
- NPI Number: 1528637493
- Provider Enumeration Date: 06/23/2021
- Last Update Date: 06/23/2021
Medicare PECOS Information:
- PECOS PAC ID: 5496157208
- Enrollment ID: I20210715001308
Medical Identifiers
Medical identifiers for Krystal Lasha Long such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1528637493 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | APN28080 (Tennessee) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Family Clinic At The Lake Pllc | 7012246069 | 2 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Krystal Lasha Long allows following entities to bill medicare on her behalf.
Entity Name | Family Clinic At The Lake Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1578125647 PECOS PAC ID: 7012246069 Enrollment ID: O20190917001247 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Krystal Lasha Long is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Krystal Lasha Long, MSN, APRN, FNP-C 11268 Highway 57, Counce, TN 38326-3802 Ph: (731) 689-4357 | Krystal Lasha Long, MSN, APRN, FNP-C 11268 Highway 57, Counce, TN 38326-3802 Ph: (731) 689-4357 |
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